Employment interventions for persons with mild cognitive disorders

Abstract

For purposes of this chapter, we will focus our review on people with mild traumatic brain injury (TBI) and the employment interventions for this population. There are many similarities between mild cognitive impairment (MCI) and mild TBI. MCI has been reported to be between 2.8 and 5.3% of the population (Larrieu et al. 2002) and typically presents as issues with memory, inefficient attention and concentration, and concerns with cognitive fatigue. Londos et al. (2008) indicate that these issues relate more to dementia in the elderly, but in a general cohort, issues such as vascular changes and depression can affect areas of cognitive functioning. Unfortunately, the annual rate of progression to dementia in MCI is in the 12-15% range (Palmer et al. 2003). People with other disabilities such as multiple sclerosis can also have cognitive limitations including fluctuations in memory capacity, word fluency, and speed of information processing (Clemmons et al. 2004). To understand clinical and vocational rehabilitation issues associated with MCI, we will utilize the mild brain injury paradigm because the cognitive issues at 6 months to a year post-injury are relatively stable. With MCI, rehabilitation and job coach personnel are generally dealing with a relatively stable condition rather than progressive cognitive deterioration, which may lead to supported or sheltered employment settings. © 2011 Springer Science+Business Media, LLC.