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

J. Clin. Med., 2023 · DOI: 10.3390/jcm12134258 · Published: June 25, 2023

Simple Explanation

This study examines the relationship between cognitive reserve (CR) and cognitive impairment in adults with spinal cord injury (SCI). Cognitive reserve refers to the brain's ability to maintain cognitive function despite damage. The study aims to determine if premorbid intelligence (pmIQ) can serve as a marker of CR in this population. The study assessed cognitive function and pmIQ in adults with SCI over a 12-month period. The results showed a strong association between mild cognitive impairment (MCI) and pmIQ, suggesting that individuals with MCI are more likely to have lower pmIQ. The findings suggest that assessing CR is important for improving the diagnosis of MCI in adults with SCI and could potentially facilitate earlier intervention to prevent cognitive decline. This may lead to improved rehabilitation outcomes.

Study Duration

12-month period

Participants

75 adults with SCI

Evidence Level

Not specified

Key Findings

1
MCI assessed by a neurocognitive screen was strongly associated with pmIQ at admission to SCI rehabilitation.
2
Individuals with MCI had significantly fewer years of education and lower TOPF scores compared to those without MCI.
3
There is a strong positive association between post-SCI cognitive outcomes and CR (or premorbid intelligence as assessed by TOPF).

Research Summary

This study investigated the relationship between cognitive reserve (CR), measured using the Test of Premorbid Functioning (TOPF), and post-spinal cord injury (SCI) cognitive outcomes, assessed by the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG). The study found a strong association between CR and post-SCI cognitive outcomes, suggesting that assessing CR should become a standard component of evaluating neurocognitive status in adults with SCI. The findings indicate that relying on a single neurocognitive screen test is insufficient and that multiple factors play a role in the relationship between CR and cognitive outcomes after SCI. Improved processes for assessing MCI after SCI are needed.

Practical Implications

Improved MCI Diagnosis

The assessment of CR should be considered to improve the diagnosis of MCI in adults with an acute SCI.

Earlier Intervention

Assessing CR could potentially facilitate earlier intervention to slow or prevent cognitive decline.

Standard Assessment Component

CR/pmIQ should become a standard component of assessing neurocognitive status in adults with an SCI to identify those at risk for cognitive decline.

Study Limitations

1
Lack of sufficient numbers in the longitudinal assessments at discharge and 12 months post-SCI.
2
Adjustments made to test administration methods (teleconferencing) have the potential to influence the outcomes of the test.
3
The study did not specifically focus on the direct effects of the pandemic.

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