Association of self-reported cognitive concerns with mobility in people with lower limb loss.
Valerie E Kelly, Sara J Morgan, Dagmar Amtmann and 2 others
PMID 27756174WHAT IT FOUND
Among established lower limb prosthesis users, greater self-reported memory, attention and decision-making concerns were linked to worse balance confidence and perceived mobility.
The link held after accounting for age, depression and amputation factors.
Key findings
01After accounting for other factors, greater cognitive concerns remained significantly associated with lower balance confidence (beta 0.14, P <0.0001).
02Greater cognitive concerns were also significantly associated with worse prosthesis-specific mobility in models that accounted for other factors (beta 0.14, P <0.0002).
03Depression had a stronger association with both balance confidence and prosthesis-specific mobility than cognitive concerns did.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot show that cognitive concerns cause poorer mobility or that treating cognitive concerns will improve mobility. Cognition and mobility were both measured by self-report, and self-reported ability may differ from actual performance. Depression was the strongest association with both mobility measures in the models that accounted for other factors, even though cognitive concerns remained significant. Only people who regularly used lower limb prostheses to walk were included, so results may not apply to occasional prosthetic users or people who mainly use a wheelchair. Some demographic and amputation variables were missing, so models that accounted for other variables used 1254 participants while 1291 completed surveys. The analysis included only variables available from the parent study, so other factors that affect cognition and mobility may have been unmeasured.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not read this as evidence that cognitive concerns cause mobility problems. The data were collected at one time and were self-reported, so the study can only show an association.