Association of physical and mental symptoms with cognition in people with spinal cord injury.
Noelle E Carlozzi, Christopher M Graves, Jonathan P Troost and 3 others
PMID 34618509WHAT IT FOUND
Most physical and mental symptoms did not correlate with objective cognitive test scores in people with spinal cord injury.
Higher pain intensity was associated with worse attention. Anxiety and fatigue correlated with perceived cognitive dysfunction, but not necessarily with actual performance deficits.
Key findings
01Higher pain intensity was associated with lower scores on a test of attention (PASAT), while other symptoms showed no association with objective cognitive outcomes.
02Higher anxiety and fatigue scores were associated with lower self-reported cognitive abilities, indicating a link between symptoms and perceived rather than objective dysfunction.
03In sensitivity analyses limited to participants with at least one impaired cognitive domain, anxiety and fatigue were associated with poorer performance on working memory and delayed memory tests respectively.
STILL TO COME
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What it does not show
The sample was relatively homogeneous with high educational attainment and was recruited from affluent areas, limiting generalizability to those with lower education or different socioeconomic backgrounds. The sample was community-dwelling and at least one year post-injury, excluding acute recovery phases where symptoms and cognitive issues might be more volatile. Mental health symptoms were measured as overall levels rather than clinically diagnosed conditions, so results may not apply to patients with diagnosed depression or anxiety. The sample had relatively low levels of depressive symptoms and generally average cognitive performance, which may have masked relationships seen in more impaired populations.
The easy way to misread this
Do not assume that patient reports of cognitive difficulty are due to objective brain-based deficits. In this study, anxiety and fatigue correlated with perceived cognitive dysfunction but not with most objective test scores, suggesting that subjective complaints may reflect symptom burden rather than measurable cognitive impairment.