600 Section - Association between Preinjury Occupational Cognitive Demand and Functional Recovery Post-Traumatic Brain Injury

After a significant traumatic brain injury (TBI), a primary concern for patients and their families is to what degree the patient will regain their previous level of functional ability. Previous research has shown that preinjury factors such as mental health disorders, education, and engagement in leisure activities influence the recovery process. This study attempts to determine whether preinjury occupation differentially influences functional outcome post-TBI. 

 

Design:

This is a retrospective cohort design utilizing data from the Southeastern Michigan Traumatic Brain Injury System. Participants with mild complicated to severe TBI were grouped based on preinjury occupation, and dichotomized into more versus less cognitively demanding roles. Functional and global recovery outcomes, including the cognitive subscale of the Functional Independence Measure (FIM-COG) and the Glasgow Outcome Scale–Extended (GOS-E), were assessed at one and two years post-injury. Independent samples t-tests were used to compare outcome scores between occupation groups at each follow-up time point.

Results:

A total of 359 individuals were included. Independent samples t-tests revealed that individuals with more cognitively demanding occupations demonstrated significantly higher FIM-COG scores at one-year post-injury compared to those in less cognitively demanding occupations (p = 0.030). Additionally, the cognitively demanding occupation group showed significantly higher GOS-E total scores at both one (p = 0.012) and two (p = 0.008) year follow-up evaluations. No significant differences were observed in motor FIM scores between groups.

Conclusion:

In this study, preinjury engagement in cognitively demanding occupations was associated with better functional and global recovery outcomes following TBI. These findings indicate that individuals with higher baseline cognitive reserve may demonstrate greater postinjury rehabilitation gains after injury. Understanding the influence of premorbid cognitive load on TBI recovery may inform clinicians’ prognostication, individualized rehabilitation planning, and early identification of patients who may require increased long-term support.