Cognition among community-dwelling individuals with spinal cord injury.
Matthew L Cohen, David S Tulsky, James A Holdnack and 5 others
PMID 29265863WHAT IT FOUND
Community-dwelling adults with spinal cord injury scored lower than matched controls on fluid cognition, especially speed and executive tasks.
Crystallized cognition was similar.
Key findings
01Adults with SCI scored lower than matched controls on the fluid cognition composite, while crystallized composite scores were similar.
02The fluid composite difference was reported as a medium effect size, and 25.0% of SCI participants scored below one standard deviation on that composite.
03Group differences remained after manual dexterity was controlled, and were mainly on processing speed, attention/inhibition, and card sorting tests.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The analysis excluded people who did not complete all cognitive tests, so it may understate problems in people with greater motor limitation. Concurrent traumatic brain injury was not consistently assessed, so some cognitive scores may reflect both spinal cord injury and brain injury. The sample was community-dwelling and not in acute rehabilitation, so the results do not describe early recovery. Some timed tests require a button press, so poor performance may reflect motor limitation rather than cognition alone. The study did not follow people over time, so it cannot show that spinal cord injury caused the cognitive differences.
The easy way to misread this
Do not treat the NIH Toolbox Cognition Battery as a motor-free assessment for everyone with spinal cord injury. Timed tests require a button press, so low scores may reflect motor limitation rather than cognition alone.