Cognitive assessment during inpatient rehabilitation after spinal cord injury, a retrospective cross-sectional study

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY Spinal cord Pub Date : 2024-09-17 DOI:10.1038/s41393-024-01035-z

Anneke A. W. Welkamp, Christel C. M. v. Leeuwen, Marcel W. M. Post, Janneke M. Stolwijk-Swüste

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Abstract

Study design

Cross-sectional study.

Objectives

Cognitive screening is underdeveloped in spinal cord injury (SCI). Therefore, the objectives of our study were: (1) to evaluate cognitive functioning of rehabilitation inpatients with recently acquired spinal cord injury (SCI) with the Montreal Cognitive Assessment (MoCA); (2) to analyse associations between patient and lesion characteristics and the MoCA scores and (3) to compare the MoCA with the cognitive domain of the Utrecht scale for Evaluation of Rehabilitation (USER).

Setting

Inpatient rehabilitation in a specialized rehabilitation centre in the Netherlands.

Methods

MOCA and USER data of inpatients between November 2020 and December 2021 were used. Correlation and regression analysis were used.

Results

Included were 98 adults aged (median) 61.6 years (range 19.5–83.6), 66% male, 26.5% traumatic SCI, 63% persons with paraplegia. MoCA and USER scores were available for 83 and 92 individuals, respectively. In 44.6% of the participants, the MoCA score was below the cut-off. Age (r = 0.31, p = 0.005) and educational level (r = 0.54 P < 0.00) were significantly correlated to the MoCA score. The MoCA and the cognitive domain of the USER were moderately correlated (r = 0.25, p = 0.03).

Conclusions

Almost half of the inpatients scored below the cut-off score on the MoCA. Since the MoCA is a validated cognitive screening tool, the moderate correlation of the MoCA and the cognitive domain of the USER suggests that the USER alone is not sufficient in detecting cognitive deficits. We recommend to screen for cognitive deficits in all people with new SCI.

Sponsorship

None.

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脊髓损伤后住院康复期间的认知评估：一项回顾性横断面研究

研究设计横断面研究。研究目的认知筛查在脊髓损伤（SCI）中尚不发达。因此，我们的研究目标是(1）使用蒙特利尔认知评估（MoCA）评估新近获得性脊髓损伤（SCI）的康复住院患者的认知功能；（2）分析患者和病变特征与 MoCA 分数之间的关联；（3）比较 MoCA 与乌得勒支康复评估量表（USER）的认知领域。方法使用 2020 年 11 月至 2021 年 12 月期间住院患者的 MOCA 和 USER 数据。结果98名成年人的年龄（中位数）为61.6岁（19.5-83.6岁），66%为男性，26.5%为创伤性SCI患者，63%为截瘫患者。分别有 83 人和 92 人获得了 MoCA 和 USER 分数。44.6% 的参与者的 MoCA 分数低于临界值。年龄（r = 0.31，P = 0.005）和教育水平（r = 0.54，P < 0.00）与 MoCA 分数显著相关。结论近一半的住院患者的 MoCA 得分低于临界值。由于 MoCA 是经过验证的认知筛查工具，MoCA 与 USER 认知领域的中度相关性表明，仅凭 USER 不足以检测认知缺陷。我们建议对所有新发 SCI 患者进行认知障碍筛查。

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来源期刊

Spinal cord 医学-临床神经学

CiteScore

4.50

自引率

9.10%

发文量

142

审稿时长

2 months

期刊介绍： Spinal Cord is a specialised, international journal that has been publishing spinal cord related manuscripts since 1963. It appears monthly, online and in print, and accepts contributions on spinal cord anatomy, physiology, management of injury and disease, and the quality of life and life circumstances of people with a spinal cord injury. Spinal Cord is multi-disciplinary and publishes contributions across the entire spectrum of research ranging from basic science to applied clinical research. It focuses on high quality original research, systematic reviews and narrative reviews. Spinal Cord''s sister journal Spinal Cord Series and Cases: Clinical Management in Spinal Cord Disorders publishes high quality case reports, small case series, pilot and retrospective studies perspectives, Pulse survey articles, Point-couterpoint articles, correspondences and book reviews. It specialises in material that addresses all aspects of life for persons with spinal cord injuries or disorders. For more information, please see the aims and scope of Spinal Cord Series and Cases.