Category: Brain Injury; Military and Veterans Affairs; Lifestyle Medicine
To examine whether tobacco smoking is associated with neuropsychological test performance after TBI. We hypothesized that tobacco smoking would predict poorer cognition after controlling for known predictors of cognition after TBI.
Design : Longitudinal cohort study
Setting : A VA Polytrauma Rehabilitation Center
Participants (or Animals, Specimens, Cadavers) : Veterans and Military Personnel discharged from inpatient neurorehabilitation, who were enrolled in the VA TBIMS study, with a 2- or 5-year post-TBI follow up interview including neuropsychological test scores (N=55) which was recently added to follow up data collection. Participants were mostly male (96%), White (87%), mean age = 38 (SD=12). TBI severity was 35% severe, 9% moderate, and 56% mild, and 50% of participants had abnormal neuroimaging. Injury mechanism was largely vehicular-related (39%).
Interventions : Not applicable.
Main Outcome Measure(s) :
Brief Cognitive Test of Adult Cognition (BTACT)
Results : The regression model was significant (F(4,46)=7.54, p<.001), but there was no statistically significant relationship between tobacco smoking and overall BTACT composite score (β=-0.20, p=0.113) after adjusting for age, education, and TBI severity. In a separate regression analysis predicting Immediate Memory (F(4,49)=8.58, p<.001), tobacco smoking nearly reached significance (β=-0.22, p=.079) after controlling for the other predictors.
These preliminary results do not support a relationship between tobacco smoking and cognition after TBI, which contrasts a prior study that examined trajectory of cognitive improvement following TBI (Durazzo et al., 2013). Our study may have been underpowered, and should be replicated with a larger sample. Also, smoking status (i.e., smoker vs. nonsmoker) is a crude measure and more sensitive measures may be needed to detect the influence of smoking on cognition.
Emily Noyes– Research Assistant, James A Haley VA Hospital, Tampa, Florida
Erin Brennan– Research Assistant, James A. Haley VA, Tampa, Florida
Amanda Royer– Research Coordinator, James A Haley VA Hospital, Tampa, Florida
Risa Nakase-Richardson– Neuropsychologist, Professor, James A. Haley Veterans Hospital / University of South Florida, Tampa, Florida
Marc Silva– Neuropsychologist, James A Haley VA Hospital, Tampa, Florida