Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Mental Health Department, Santa Casa of Sao Paulo Medical Science School, São Paulo, SP, Brazil.
Spinal Cord. 2024 Jun;62(6):336-342. doi: 10.1038/s41393-024-00986-7. Epub 2024 Apr 12.
Using a cross-sectional design, we extracted sociodemographic and clinical data from 488 Spinal Cord Injury (SCI) patients during their initial assessment before receiving intensive rehabilitation treatment.
The primary objectives of this study were to ascertain the prevalence of cognitive impairment in the study sample and specify the key clinical and demographic predictors of cognitive functioning in SCI patients.
Lucy Montoro Rehabilitation Institute (LMRI), University of Sao Paulo, Sao Paulo, Brazil.
We utilized independent univariate and multivariate regression models with the Montreal Cognitive Assessment (MoCA) scale, adapted for individuals with visual impairment. Moreover, we consider scores from the execution tasks (visuospatial/executive) as the dependent variable.
Our findings demonstrate that approximately 80% of the evaluated study sample exhibited cognitive impairment. Through the multivariate regression models, we show that several factors, including age, education, depression levels, and the use of analgesics and/or opioids, are significant predictors of total cognitive scores. These factors are independent of the clinical features associated with SCI, such as age, sex, education, and time since the injury.
The results indicate a high prevalence of significant cognitive impairment within the sample, with age, education, depression levels, and the use of analgesics and/or opioids emerging as the primary predictors of total cognitive scores, independent of the clinical features correlated to SCI. These findings hold significant implications for both clinical research and practice, offering valuable guidance for comprehensive management throughout hospitalization and rehabilitation.
采用横断面设计，我们从 488 名脊髓损伤（SCI）患者在接受强化康复治疗前的初始评估中提取了社会人口统计学和临床数据。
本研究的主要目的是确定研究样本中认知障碍的患病率，并确定 SCI 患者认知功能的关键临床和人口统计学预测因素。
巴西圣保罗大学 Lucy Montoro 康复研究所（LMRI）。
我们使用了独立的单变量和多变量回归模型，使用蒙特利尔认知评估（MoCA）量表，适用于视力障碍者。此外，我们将执行任务（视觉/执行）的分数视为因变量。
我们的研究结果表明，大约 80%的评估研究样本存在认知障碍。通过多变量回归模型，我们表明，包括年龄、教育程度、抑郁水平以及使用镇痛药和/或阿片类药物在内的几个因素是总认知评分的重要预测因素。这些因素与与 SCI 相关的临床特征无关，如年龄、性别、教育程度和受伤时间。
结果表明，样本中存在显著认知障碍的高患病率，年龄、教育程度、抑郁水平以及镇痛药和/或阿片类药物的使用是总认知评分的主要预测因素，与与 SCI 相关的临床特征无关。这些发现对临床研究和实践具有重要意义，为住院和康复期间的全面管理提供了有价值的指导。
