摘要:

Several case-control studies have reported head injury to be more common among patients with Alzheimer's disease (AD) than healthy elderly controls. The present study sought to determine whether milder head injury is also a risk factor for AD. Furthermore, it was hypothesized that head injury would be more common among AD patients without a genetic risk for the disease. History of head injury in 68 consecutive cases of probable or definite AD and 34 non-demented control subjects was ascertained from their spouses. Head injury was reported in 20 of the AD patients (29%), and in only one control subject (2.9%) (odds ratio = 13.75). Twenty per cent of the familial and 43.5% of the sporadic AD cases reportedly had a premorbid head injury (odds ratio = 3.08). Head injury had no effect on age of dementia onset. The results indicate that head trauma may be a predisposing factor to AD, particularly in the absence of a clear genetic contribution.

ISSN:0269-9052    

DOI:10.3109/02699059509008194

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This article describes a pilot programme initiated in 1991 to address the problems of substance abuse among persons who have experienced traumatic brain injury (TBI). The model of treatment is community-based, using an interdisciplinary staff with expertise in TBI, vocational rehabilitation, and substance abuse treatment, to support and enhance existing services in the client's own community. The primary method of intervention is resource and service coordination. Six principles that serve as the underpinnings of the model are described, as are core and supplemental services and staffing patterns. Innovative components of the programme include the theoretical model of changing addictive behaviours used to guide treatment, and the development of community teams to facilitate a coordinated and integrated approach. The programme has relatively low start-up costs and can serve both urban and rural populations. Clinical experience and initial programme evaluation results suggest that substance abuse and vocational rehabilitation goals can be effectively attained using this model of service delivery.

ISSN:0269-9052    

DOI:10.3109/02699059509008195

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

A physiological analysis of the lip and tongue function of a group of 18 severely closed-head injured (CHI) subjects was performed using lip and tongue force transduction systems. Lip and tongue strength, endurance and rate of repetitive movements were assessed on four non-speech tasks: maximum strength, sustained maximum strength, repetition of 10 maximum strength compressions, and maximum repetition rate. The values recorded were compared to those achieved by a group of 18 non-neurologically impaired subjects, matched for age and sex, who served as the controls. The results of the study indicated that the CHI subjects demonstrated a significant impairment of lip and tongue function based on strength, endurance and rate of repetitive movements, compared to the controls. While Up function was found to be significantly impaired on several measures of strength and endurance, tongue function was noted to be more severely compromised. The CHI subjects were found to exhibit a significantly reduced rate of repetitive movements of the lips and tongue. The results are discussed in relation to the effects of CHI on neuromuscular function and differential subsystem impairment in dysarthria. The clinical implications of these findings are also discussed in relation to the treatment of articulatory disturbances following severe CHI.

ISSN:0269-9052    

DOI:10.3109/02699059509008196

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

There are few clinical tools available to assess communication skills following closed-head injury. This paper describes one such task in which the subject is required to explain a board game to a naive listener. The explanation is taped, transcribed and the content is quantified. Reliability studies demonstrated that the test can be consistently scored. A group of 43 normal subjects was investigated, and some variation in peformance according to age and educational background was revealed. A group of 20 brain-injured male adults with executive-type deficits were then compared to a matched subgroup of the controls. The clinical group produced less essential information and relatively more unnecessary information than their non-brain-damaged counterparts. Qualitative features of discourse disorganization were also revealed.

ISSN:0269-9052    

DOI:10.3109/02699059509008197

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This study investigated unawareness of memory loss in 48 severe closed-head injury patients. Awareness was measured as the correlation of patients' memory test scores with their self-ratings on the Everyday Memory Questionnaire (EMQ). Patients who endorsed atypical memory failures on the EMQ were classified as invalid responders. Invalid responders had poorer memory test performances and a higher rate of focal left hemispheric lesions, but did not report greater emotional symptoms. Correlations between memory test scores and memory self-ratings were weaker among invalid responders or those classified as depressed, and stronger among valid responders, especially those classified as non-depressed. The results indicate that the validity of memory self-reports is influenced by both neurogenic and psychogenic factors, and suggest that invalid responding is an important problem with self-reports by brain-injured patients.

ISSN:0269-9052    

DOI:10.3109/02699059509008198

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

It has been widely assumed that most of the recovery following severe traumatic brain injury (TBI) occurs within the first 6 months, and that virtually all of the recovery occurs within the first 1-2 years post-injury. In an effort to evaluate the long-term recovery of patients who had sustained severe TBI, we interviewed the relatives and significant others of 20 patients who had sustained TBI at least 5 years earlier, using a modified version of the Portland Adaptability Inventory. Retrospective ratings were collected to evaluate the patients' psychosocial, cognitive, physical, and emotional status prior to their injury, and at 1, 2, 5, and an average of 10-3 years post-injury. The results indicated that TBI patients exhibit significant improvements in their social, cognitive, physical, and emotional functioning after 2 years post-injury regardless of the severity of their initial brain trauma. These data suggest that patients who sustain severe TBI continue to make gradual improvements in their functioning for at least 10 years post-injury. Our findings contradict the widely held assumption that the recovery process ends after 1 or 2 years post-injury.

ISSN:0269-9052    

DOI:10.3109/02699059509008199

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This prospective study examined the effect of work environments on return to work for persons with brain injuries. Participants (n = 37) were individuals placed into supported employment by six placement agencies. All were assessed using the Vocational Integration Index (VII), an observational instrument for rating the opportunities for integration (Job Scale) and the extent to which an employee benefits from those opportunities (Consumer Scale). Individuals who retained their jobs for 6 months (n = 19) had been rated higher on all subscales and total scores for the VII, with seven of eight subscales statistically significant. Findings are discussed in regard to improving employment outcomes for persons with severe brain injuries.

ISSN:0269-9052    

DOI:10.3109/02699059509008200

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Although evidence exists for delayed recovery after traumatic brain injury, patients who do not receive rehabilitation early after their injuries often remain permanendy in long-term care facilities. Case reports of five severely brain-injured persons who were discharged into long-term nursing care facilities for at least 1 year before initial rehabilitation admission are discussed. After prescreening for evidence of functional improvement, these patients were admitted to a rehabilitation unit with the goal of community discharge. Functional improvement was evaluated using the Functional Independence Measure (FIM) and additional categories of function. Community discharge was successfully achieved in all five patients, who demonstrated particular improvement in bathing, transfers, memory, bowel management, problem solving and independence during waking hours. Further efforts should be made to identify patients in long-term care facilities who might benefit from rehabilitation services, and to identify those factors which contribute to successful community discharge.

ISSN:0269-9052    

DOI:10.3109/02699059509008201

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor