Cognitive Reserve and Its Association with Cognitive and Mental Health Status Following an Acute Spinal Cord Injury

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Jul 14

PMID 37445291

Authors

Mohit Arora

Ilaria Pozzato

Candice McBain

Yvonne Tran

Danielle Sandalic

Daniel Myles

James Walter Middleton

Ashley Craig

Affiliations

Soon will be listed here.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

References

Baldassin V, Shimizu H, Fachin-Martins E . Computer assistive technology and associations with quality of life for individuals with spinal cord injury: a systematic review. Qual Life Res. 2018; 27(3):597-607. DOI: 10.1007/s11136-018-1804-9. View

Walterfang M, Siu R, Velakoulis D . The NUCOG: validity and reliability of a brief cognitive screening tool in neuropsychiatric patients. Aust N Z J Psychiatry. 2006; 40(11-12):995-1002. DOI: 10.1080/j.1440-1614.2006.01923.x. View

Krupp L, Larocca N, Steinberg A . The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989; 46(10):1121-3. DOI: 10.1001/archneur.1989.00520460115022. View

Craig A, Tran Y, Arora M, Pozzato I, Middleton J . Investigating Dynamics of the Spinal Cord Injury Adjustment Model: Mediation Model Analysis. J Clin Med. 2022; 11(15). PMC: 9369731. DOI: 10.3390/jcm11154557. View

Craig A, Hancock K, Chang E, Dickson H . The effectiveness of group psychological intervention in enhancing perceptions of control following spinal cord injury. Aust N Z J Psychiatry. 1998; 32(1):112-8. DOI: 10.3109/00048679809062717. View

Nightingale T, Zi Zheng M, Sachdeva R, Phillips A, Krassioukov A . Diverse cognitive impairment after spinal cord injury is associated with orthostatic hypotension symptom burden. Physiol Behav. 2019; 213:112742. DOI: 10.1016/j.physbeh.2019.112742. View

Craig A, Hancock K, Chang E, Dickson H . Immunizing against depression and anxiety after spinal cord injury. Arch Phys Med Rehabil. 1998; 79(4):375-7. DOI: 10.1016/s0003-9993(98)90136-8. View

Siddall P, McClelland J, Rutkowski S, Cousins M . A longitudinal study of the prevalence and characteristics of pain in the first 5 years following spinal cord injury. Pain. 2003; 103(3):249-257. DOI: 10.1016/S0304-3959(02)00452-9. View

Craig A, Moses P, Tran Y, McIsaac P, Kirkup L . The effectiveness of a hands-free environmental control system for the profoundly disabled. Arch Phys Med Rehabil. 2002; 83(10):1455-8. DOI: 10.1053/apmr.2002.34624. View

10.

Kroenke K, Spitzer R, Williams J . The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9):606-13. PMC: 1495268. DOI: 10.1046/j.1525-1497.2001.016009606.x. View

11.

Teymoori A, Gorbunova A, Haghish F, Real R, Zeldovich M, Wu Y . Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury. J Clin Med. 2020; 9(3). PMC: 7141536. DOI: 10.3390/jcm9030873. View

12.

Craig A, Guest R, Tran Y, Middleton J . Cognitive Impairment and Mood States after Spinal Cord Injury. J Neurotrauma. 2016; 34(6):1156-1163. DOI: 10.1089/neu.2016.4632. View

13.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

14.

Lazzaro I, Tran Y, Wijesuriya N, Craig A . Central correlates of impaired information processing in people with spinal cord injury. J Clin Neurophysiol. 2013; 30(1):59-65. DOI: 10.1097/WNP.0b013e31827edb0c. View

15.

Sandalic D, Craig A, Arora M, Pozzato I, Simpson G, Gopinath B . A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol. BMC Neurol. 2020; 20(1):341. PMC: 7484605. DOI: 10.1186/s12883-020-01899-7. View

16.

Loong T . Understanding sensitivity and specificity with the right side of the brain. BMJ. 2003; 327(7417):716-9. PMC: 200804. DOI: 10.1136/bmj.327.7417.716. View

17.

Krassioukov A, Claydon V . The clinical problems in cardiovascular control following spinal cord injury: an overview. Prog Brain Res. 2005; 152:223-9. DOI: 10.1016/S0079-6123(05)52014-4. View

18.

Sandalic D, Tran Y, Arora M, Middleton J, McBain C, Myles D . Improving Assessment of Cognitive Impairment after Spinal Cord Injury: Methods to Reduce the Risk of Reporting False Positives. J Clin Med. 2023; 12(1). PMC: 9820950. DOI: 10.3390/jcm12010068. View

19.

Craig A, Tran Y, Guest R, Middleton J . Trajectories of Self-Efficacy and Depressed Mood and Their Relationship in the First 12 Months Following Spinal Cord Injury. Arch Phys Med Rehabil. 2018; 100(3):441-447. DOI: 10.1016/j.apmr.2018.07.442. View

20.

Nadarajah M, Mazlan M, Abdul-Latif L, Goh H . Test-retest reliability, internal consistency and concurrent validity of Fatigue Severity Scale in measuring post-stroke fatigue. Eur J Phys Rehabil Med. 2016; 53(5):703-709. DOI: 10.23736/S1973-9087.16.04388-4. View