Executive Function, Dexterity, and Discharge Disposition in Older Intensive Care Unit Survivors.
Maya N Elías, Cindy L Munro, Zhan Liang
PMID 33130868WHAT IT FOUND
In older ICU survivors, worse attention and task switching were linked to worse hand dexterity.
Those discharged to a facility had lower dexterity and task-switching scores than those discharged home.
Key findings
01The average fully corrected dexterity T score was 30.04 (8.94), about 2 SDs below healthy community-dwelling older adults; only 1 scored above 50.
02After adjusting for covariates, attention scores were positively associated with dexterity scores (β = 0.375, P = .03), and cognitive flexibility scores were positively associated with dexterity scores (β = 0.698, P = .001).
03Participants discharged to a facility had worse mean dexterity (26.71 [6.14]) and cognitive flexibility (35.59 [6.79]) scores than participants discharged home (dexterity 36.33 [10.30]; cognitive flexibility 44.89 [10.43]).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
30 participants were enrolled and 26 completed all measures. Recruitment was convenience sampling from 12 medical or surgical units at one university-affiliated level I trauma hospital. Participants were English-speaking, functionally independent before admission, and had no preexisting dementia diagnosis. Delirium could not be adjusted for because clinical documentation of ICU delirium was considered unreliable. The regression analyses were exploratory, and the small sample allowed only selected covariates. One participant was lost to follow-up at an out-of-network hospital.
The easy way to misread this
Do not read the dexterity differences as proof that poor dexterity causes facility discharge. Only 26 participants completed all measures, and delirium could not be adjusted for, so the associations may reflect other post-ICU factors.