Archives of physical medicine and rehabilitation · 2025
Understanding Multidimensional Apathy in Traumatic Brain Injury.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Rankin Meg, Ponsford Jennie, Hicks Amelia J, Phyland Ruby K, Chong Trevor T-J, Spitz Gershon
Аннотация
OBJECTIVE: To investigate whether individuals with moderate-to-severe chronic traumatic brain injury (TBI) exhibit higher levels of apathy-particularly in behavioral, cognitive, and emotional domains-compared with neurotypical controls, and to examine the association between apathy severity and injury-related factors, productivity, and quality of life.
DESIGN: Cross-sectional, cohort study.
SETTING: Community.
PARTICIPANTS: Participants were sampled from a larger longitudinal study of individuals recruited from consecutive inpatient TBI admissions to a rehabilitation hospital. We analyzed data from 136 participants with moderate-to-severe TBI (53% men; Mage=51.8y; Mtime postinjury=13.8y, range=0.25-35.2) and 78 neurotypical controls (48.75% men; Mage=50.3y).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Apathy Evaluation Scale, injury-related measures, Satisfaction with Life Scale, and coded productivity measure based on employment status.
RESULTS: Results indicated that individuals with TBI had significantly higher overall apathy (P=.031) and behavioral apathy (P=.037) than neurotypical controls, but did not differ in the cognitive or emotional subtypes. Individuals with TBI were 1.98 times more likely to exhibit clinically significant apathy (odds ratio=1.98; 95% CI, 0.98-4.22). Glasgow Coma Scale score, posttraumatic amnesia duration, age at the time of injury, time post-injury, and abnormal computed tomography scan were not significantly related to any apathy subtype. Higher global apathy scores were significantly associated with lower productive activities (P=.021), whereas higher global and behavioral apathy were significantly associated with lower life satisfaction (P<.001, P=.021, respectively).
CONCLUSIONS: These findings underscore the elevated prevalence of apathy after TBI, which may manifest primarily in the behavioral domain. The association between elevated apathy and lower functioning and reduced life satisfaction highlights that apathy is a key factor influencing long-term outcomes. Identifying and addressing apathy, especially its behavioral component, may therefore be critical for improving functional recovery and quality of life in this population.
DESIGN: Cross-sectional, cohort study.
SETTING: Community.
PARTICIPANTS: Participants were sampled from a larger longitudinal study of individuals recruited from consecutive inpatient TBI admissions to a rehabilitation hospital. We analyzed data from 136 participants with moderate-to-severe TBI (53% men; Mage=51.8y; Mtime postinjury=13.8y, range=0.25-35.2) and 78 neurotypical controls (48.75% men; Mage=50.3y).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Apathy Evaluation Scale, injury-related measures, Satisfaction with Life Scale, and coded productivity measure based on employment status.
RESULTS: Results indicated that individuals with TBI had significantly higher overall apathy (P=.031) and behavioral apathy (P=.037) than neurotypical controls, but did not differ in the cognitive or emotional subtypes. Individuals with TBI were 1.98 times more likely to exhibit clinically significant apathy (odds ratio=1.98; 95% CI, 0.98-4.22). Glasgow Coma Scale score, posttraumatic amnesia duration, age at the time of injury, time post-injury, and abnormal computed tomography scan were not significantly related to any apathy subtype. Higher global apathy scores were significantly associated with lower productive activities (P=.021), whereas higher global and behavioral apathy were significantly associated with lower life satisfaction (P<.001, P=.021, respectively).
CONCLUSIONS: These findings underscore the elevated prevalence of apathy after TBI, which may manifest primarily in the behavioral domain. The association between elevated apathy and lower functioning and reduced life satisfaction highlights that apathy is a key factor influencing long-term outcomes. Identifying and addressing apathy, especially its behavioral component, may therefore be critical for improving functional recovery and quality of life in this population.