Story Retell of Older Adults with TBI
Objectives: Traumatic brain injury (TBI) is a risk factor for negative social outcomes across the lifespan. However, little is known about the social functioning of older adults with TBI. This gap is concerning because TBI incidence has risen among older adults, and this population is especially vulnerable to the negative effects of social isolation. The objective of this study was to examine one aspect of social functioning in older adults with TBI, narrative discourse. Younger adults with TBI have been characterized as less productive and efficient story tellers. Older age is also associated with declines in narrative efficiency. We therefore hypothesized that older adults with TBI would produce shorter stories characterized by more frequent repetitions and revisions than typically aging older adults.
Methods: Participants were 6 adults aged 55 years and older who had sustained a moderate-severe TBI and 6 comparison participants, matched to the TBI group for age and sex. Data were accessed from the TalkBank database. As part of the TalkBank protocol, participants completed a story retell task in which they reviewed a Cinderella picture book and then retold the story. These narratives were transcribed and each transcript was analyzed for language production (total utterances, total words), lexical diversity (Moving Average Type-Token Ratio), syntactic complexity (Mean Length of Utterance (words), verbs per utterance), and fluency (restarts, repetitions). All participants gave written informed consent to have their language samples contributed to the TalkBank database and this study was approved by the University of North Carolina – Chapel Hill Institutional Review Board.
Results: Results indicated that on average the group of older adults with TBI produced significantly shorter stories than the comparison group, however this difference was statistically significant only when measured by total words produced (U = 5.00, p = .40), and not total utterances (U = 9.00, p = .18). Lexical diversity was similar between the groups (U = 13.00, p = .49) and while the TBI group’s stories were less syntactically complex on average, these differences were not significant (MLU: U = 11.00, p = .31; Verbs/Utterance: U = 10.00, p = .24). The groups were also similar in the number of restarts (U = 14.00, p = .59) and repetitions (U = 13.50, p = .49), though on average the TBI group had fewer restarts and repetitions.
Conclusions: Results of this preliminary study suggest that like younger individuals, older adults might be at risk for narrative discourse impairments, particularly in language production. This preliminary data must be interpreted with caution given the small sample size, but if replicated in larger studies, could provide a critical description of

Narrative Discourse of Older Adults with Traumatic Brain Injury