Cognitive functioning following traumatic brain injury in older adults: associations with social participation and health-related quality of life.

To describe objective and subjective cognitive functioning older adults who sustained TBI at age 65 or over, and to determine whether cognitive functioning is associated with health-related quality of life (HRQoL) and social participation. The sample consisted of 40 individuals with TBI (mean age = 73 years; 65% mild, 35% moderate/severe TBI). On average 15 months post-injury, they completed measures of objective and subjective cognitive functioning (Telephone Interview for Cognitive Status-Modified, Alphaflex, Medical Outcomes Study Cognitive Functioning Scale), HRQoL (SF-12), and social participation (Participation Assessment with Recombined Tools - Objective). Mean score for objective cognitive functioning was lower than normative values, while mean scores for executive functioning and subjective cognitive functioning were comparable to normative values. There was no relationship between objective and subjective measures. Subjective cognitive functioning and (to a lesser extent) global objective cognitive functioning were significantly associated with mental HRQoL but not with physical HRQoL or social participation. These results underscore the importance of considering both subjective perception and objective performance when assessing and intervening on cognition to promote better mental HRQoL in older adults with TBI.