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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

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

作者信息

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

机构信息

Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.

University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.

出版信息

Spinal Cord. 2024 Dec;62(12):683-689. doi: 10.1038/s41393-024-01035-z. Epub 2024 Sep 17.

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.

摘要

研究设计

横断面研究。

目的

脊髓损伤(SCI)患者的认知筛查尚不完善。因此,本研究的目的是:(1)使用蒙特利尔认知评估量表(MoCA)评估近期发生脊髓损伤(SCI)的康复住院患者的认知功能;(2)分析患者及损伤特征与MoCA评分之间的关联;(3)将MoCA与乌得勒支康复评估量表(USER)的认知领域进行比较。

地点

荷兰一家专业康复中心的住院康复部。

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。采用相关性和回归分析。

结果

纳入98名成年人,年龄(中位数)为61.6岁(范围19.5 - 83.6岁),男性占66%,创伤性SCI占26.5%,截瘫患者占63%。分别有83名和92名个体获得了MoCA和USER评分。44.6%的参与者MoCA评分低于临界值。年龄(r = 0.31,p = 0.005)和教育水平(r = 0.54,P < 0.00)与MoCA评分显著相关。MoCA与USER的认知领域呈中度相关(r = 0.25,p =

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