Relative contribution of attention and memory toward disorientation or post-traumatic amnesia in an acute brain injury sample

Primary objective: To examine the relative contribution of attention and memory to orientation/disorientation following moderate-to-severe brain injury. It was hypothesized that attention would be a comparable contributor to orientation, compared to memory; suggesting assessing attention has a role in understanding and estimating duration of post-traumatic amnesia.

Research design: One hundred and five brain-injured inpatients were divided into three groups of high, moderate or low orientation. ANOVA was run on attention, memory and (as a control) language scores to examine group differences. Correlational analysis was run between orientation items and attention and memory indexes to examine the relative contribution of attention and memory on specific orientation item performance. Multiple regression examined the contribution of memory and attention to being oriented.

Methods and pocedures: Patients’ orientation, attention, memory and language were assessed during their inpatient rehabilitation.

Main outcomes and results: Groups differed significantly and attention recovered more sharply between low and moderate orientation states compared to memory and language recover. Memory contributed most to orientation, followed closely by attention, both surpassing language. Attention most related to temporal estimation, while memory most related to retrieval of well-consolidated memories.

Conclusions: Attention contributes significantly to orientation, although to a slightly lesser degree than memory. Attention should be assessed routinely. The relative ‘load’ and contribution of attention to orientation and answering orientation-type questions is discussed.