Relationship between cognition and functional outcomes after dysvascular lower extremity amputation: a prospective...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Psychology

Background:

• Lower extremity amputation significantly impacts functional outcomes.
• Cognitive function is crucial for rehabilitation success post-amputation.
• Understanding cognitive-functional associations aids in personalized rehabilitation strategies.

Purpose of the Study:

• To investigate the relationship between cognitive screening and neuropsychological tests with functional outcomes.
• To assess cognitive performance at 6 weeks and 4 months post-amputation.
• To correlate cognitive measures with functional outcomes at 12 months post-amputation.

Main Methods:

• Prospective cohort study across four medical centers.
• Inclusion of male Veterans undergoing first lower extremity amputation.
• Utilized demographic data, cognitive tests (Short Portable Mental Status Questionnaire), neuropsychological measures, and functional outcome scales (Locomotor Capability Index-5, Gronigen Activity Restriction Scale).

Main Results:

• Improved Short Portable Mental Status Questionnaire scores at 4 months correlated with better 12-month mobility and social integration.
• Enhanced attention and working memory at 6 weeks predicted increased prosthetic use at 12 months.
• Better verbal memory at 6 weeks was associated with greater 12-month social integration, community participation, and prosthetic use.

Conclusions:

• Brief cognitive assessments are valuable additions to general mental status screening in amputation rehabilitation.
• Specific cognitive domains show differential associations with functional outcomes.
• Cognitive assessment findings can guide individualized amputation rehabilitation planning.