New Gist-Reasoning Test Helps Predict Daily Functioning For People With TBI
New research from University of Texas at Dallas’ Center for BrainHealth finds that individuals with traumatic brain injury (TBI) experience significantly more difficulty with gist reasoning than traditional cognitive tests, according to the report published in the Journal of Clinical and Experimental Neuropsychology.
The researchers used a new cognitive assessment they created to show post-TBI gist-reasoning ability is useful for predicting the performance of daily life skills than traditional cognitive tests.
“Assessing how well one understands and expresses big ideas from information they are exposed to, commonly known as an ability to ‘get the gist’, is a window into real-life functionality. I do not know of any other paper-and-pencil test that can tell us both,” said Dr. Asha Vas, research scientist at the Center for BrainHealth and lead author of the study.
The team of researchers evaluated 70 participants ranging in age from 25 to 55, including 30 participants who had a traumatic brain injury one year or more before the study. All individuals participating had similar socioeconomic status, educational backgrounds, and IQ.
The participants were given a set of standardized cognitive assessments, including tests of working memory, inhibition, and switching. They were also given the gist-reasoning assessment developed by the researchers which evaluates the number of gist-based ideas – not explicit facts – they are able to abstract from complex texts.
“Although performance on traditional cognitive tests is informative, widely used measures do not paint the full picture. Adults with TBI often fare average or above on these structured measures. All too often, adults with brain injury have been told that they ought to be fine. In reality, they are not doing and thinking like they used to prior to the injury and struggle managing everyday life responsibilities years after the injury,” Vas said.
“Gist reasoning could be a sensitive tool to connect some of those dots as to why they are having trouble with real-life functionality despite falling into the range of ‘normal’ on other cognitive tests.”
The researchers evaluated the daily life functions of the individuals with TBI using a self-rated questionnaire covering topics such as problem solving at work, managing finances, organizing grocery lists at home and social interactions.
The researchers found almost 70 percent of the TBI group received lower scores on gist reasoning compared to the control group. The TBI groups’ decreased gist-reasoning performance indicated a direct correlation with difficulties at work and home. The results of all standard cognitive tests predicted daily function with 45 percent accuracy in individuals with TBI, but adding the gist-reasoning assessment increased the accuracy to 58 percent.
“TBI needs to be treated as a chronic condition. While acute recovery care is essential, long-term monitoring and effective interventions are necessary to mitigate persistent or later emerging deficits and ensure maximum brain regeneration and cognitive performance,” said Dr. Sandra Chapman, founder and chief director at the Center for BrainHealth and Dee Wyly Distinguished University Professor in the School of Behavioral and Brain Sciences.
“We don’t want anyone who has survived a TBI to think that if gist reasoning and day-to-day life is challenging today that it will always be that way, because gist reasoning can be improved.”