Association of physical and mental symptoms with cognition in people with spinal cord injury

Rehabil Psychol, 2022 · DOI: · Published: November 1, 2022

Spinal Cord Injury Mental Health Neurology

Simple Explanation

This research investigates how physical and mental health symptoms relate to cognitive abilities in individuals with spinal cord injuries (SCI). It looks at self-reported symptoms like pain, fatigue, anxiety, and depression, and compares them to scores on cognitive tests. The study found that pain was associated with poorer attention, while anxiety and fatigue were linked to lower self-perceived cognitive function. Among those with cognitive impairment, anxiety also correlated with lower working memory, and fatigue with lower delayed memory. These findings suggest that managing pain, anxiety, and fatigue could potentially improve cognitive function in people with SCI. It also highlights the importance of recognizing the different ways cognitive function can be measured (objective tests versus self-report).

Study Duration

Not specified

Participants

174 community dwelling adults with SCI

Evidence Level

Not specified

Key Findings

1
Greater pain intensity was associated with lower scores on the Paced Auditory Serial Addition Test (PASAT), indicating poorer attention.
2
Higher anxiety and fatigue levels were associated with lower self-reported cognitive ability, as measured by the PROMIS Cognitive Abilities scale.
3
Among individuals with at least one impaired cognitive domain, anxiety was negatively correlated with List Sorting (working memory) and fatigue was negatively correlated with CVLT: Long-Delay Free Recall (delayed memory).

Research Summary

The study evaluated the association between mental and physical symptoms and both perceived and objective cognitive function in people with SCI. Symptoms were generally not associated with objective cognitive performance, except for pain being associated with worse performance on an attention test. Greater anxiety and fatigue were associated with greater perceived cognitive dysfunction, and among those with clinically significant cognitive impairments, anxiety and fatigue were associated with poorer performance on tests of working memory and delayed memory, respectively.

Practical Implications

Targeted symptom management

Treatment of pain, anxiety, and fatigue may have positive effects on cognitive function in people with SCI.

Distinct cognitive assessments

Researchers and clinicians should recognize that objective and subjective measures of cognition provide distinct information about cognition in persons with SCI.

Clinical follow-up warranted

Cognitive complaints are not simply an artifact of depressive symptoms; and thus, follow-up of these complaints is clinically warranted.

Study Limitations

1
The sample was relatively homogenous, especially with regard to educational attainment, limiting generalizability to those with lower educational attainment.
2
The sample was collected in relatively affluent areas.
3
Mental symptoms reflected overall levels of symptomatology rather than clinically significant symptoms.

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