Arora Mohit, Pozzato Ilaria, McBain Candice, Tran Yvonne, Sandalic Danielle, Myles Daniel, Middleton James Walter, Craig Ashley
The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia.
John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia.
J Clin Med. 2023 Jun 25;12(13):4258. doi: 10.3390/jcm12134258.
Mild cognitive impairment (MCI) is a common secondary condition associated with spinal cord injury (SCI). Cognitive reserve (CR) is believed to protect against cognitive decline and can be assessed by premorbid intelligence (pmIQ). Despite the potential utility of pmIQ as a complementary metric in the evaluation of MCI in SCI, this approach has been infrequently employed. The purpose of this study was to examine the association between MCI and pmIQ in adults with SCI with the aim of exploring the potential value of pmIQ as a marker of CR in this population.
Cognitive function was assessed on three occasions in adults with SCI over a 12-month period post-injury, and pmIQ was assessed once at baseline. Demographic and mental health measures were also collected, and logistic regression was conducted to determine the strength of association between pmIQ and MCI while adjusting for factors such as mental health and age.
The regression analysis revealed that at the time of admission to SCI rehabilitation, the MCI assessed by a valid neurocognitive screen was strongly associated with pmIQ. That is, if a person has MCI, there was 5.4 greater odds ( < 0.01) that they will have poor pmIQ compared to a person without MCI after adjustment for age and mental health.
The assessment of CR is an important area that should be considered to improve the process of diagnosing MCI in adults with an acute SCI and potentially facilitate earlier intervention to slow or prevent cognitive decline.
轻度认知障碍（MCI）是与脊髓损伤（SCI）相关的常见继发性病症。认知储备（CR）被认为可预防认知衰退，并且可以通过病前智力（pmIQ）进行评估。尽管pmIQ作为评估SCI患者MCI的补充指标具有潜在效用，但这种方法很少被采用。本研究的目的是检查SCI成年患者中MCI与pmIQ之间的关联，以探索pmIQ作为该人群CR标志物的潜在价值。
在SCI成年患者受伤后的12个月内，分三次评估其认知功能，并在基线时评估一次pmIQ。还收集了人口统计学和心理健康指标，并进行逻辑回归分析，以确定在调整心理健康和年龄等因素后pmIQ与MCI之间的关联强度。
回归分析显示，在进入SCI康复治疗时 通过有效的神经认知筛查评估的MCI与pmIQ密切相关。也就是说，在调整年龄和心理健康因素后，与没有MCI的人相比，患有MCI的人pmIQ较差的几率高5.4倍（<0.01）。
CR评估是一个重要领域，应予以考虑，以改善急性SCI成年患者MCI的诊断过程，并可能促进早期干预，以减缓或预防认知衰退。
