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Preliminary Analysis of Concussion Underreporting in Aging and Dementia Research

Sarah Garfield1, Madison McGuire,1 Emily F. Matusz2, Olivia M. Emanuel2, Shannon Y. Lee2, Jessica Bove2, & Breton M. Asken2

1Department of Liberal Arts & Sciences, 2University of Florida, Department of Clinical and Health Psychology

Methods, continued

Background

Methods

Application

Application

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Results, continued

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Conclusion

Objective

To investigate how older adults with neurodegenerative disease changed their reporting of frequency of prior concussions after being provided a formal definition of concussion.

  • Many studies likely underestimate concussion history in older adults.
  • Using a formal definition of concussions will likely increase reporting of prior concussion history in older adults
  • Improving consistency of concussion history data collection across studies will help minimize the risk of underreporting.

Participants: 167 older adults (age = 70.1±8.3; 39% female; 96.4% White, 1.2% Black/African American, 1.2% Asian American, 1.2% Mixed) from the Fixel Institute of Neurological Disorders with a range of neurological disorders .

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Outcome Measure: Comprehensive head trauma survey from the Boston University Head Impact Exposure Assessment.

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Statistical Analysis: Wilcoxon signed-ranks test was used to compare the number of reported head injuries pre- and post-definition.

Acknowledgements

Preliminary Data

  • 56 (33.5%) participants reported having a concussion pre-definition, which increased to over 60% post-definition
  • Frequency of the number of reported repeated (2+) concussions increased from pre-definition (18%) to post-definition (39%)
  • Self-reported concussion history significantly increased after providing a formal definition for concussion (p <.001)

🡪 Pre-definition: 1.1±2.4

🡪 Post-definition: 2.0±3.3;

  • ~ 1/3 (32.6%) of participants increased reported concussion frequency after being provided a formal definition of concussion.

Race

Step 1: Pre-Concussion Definition Prompt:

“As best as you can remember, how many total concussions did you have during your life?”

  • History of concussion, especially repeated concussions, is associated with poor later-life neurological health.
  • Understanding the role of concussion in brain health first requires accurate detection of prior injuries.
  • The underreporting of concussion can lead to inaccurate detection.

Thank you to Fixel Neurological Institute for access to patient data.

Step 2: Post-Concussion Definition Prompt:

“Some people have the misconception that concussions only happen when you black out after a hit to the head or when the symptoms last for a while. But, in reality, a concussion has occurred anything you have had a blow to the head that caused you to have symptoms for any amount of time. These include: blurred or double vision, seeing stars, sensitivity to light or noise, headache, dizziness or balance problems, nausea, vomiting, trouble sleeping, fatigue, confusion, difficulty remembering, difficulty concentrating, or loss of consciousness. Whenever anyone gets a “ding” or their “bell rung,” that too is a concussion. Based on that definition of a concussion, as best as you can remember, how many total concussions did you have during your life? (It may be difficult to recall an exact number, but please take your best guess if at all possible.)”

Results

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