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Neuropsychological function in peripheral vascular disease amputee patients
N A Phillips1, C C Mate-Kole, R L Kirby
1Department of Psychology, Dalhousie University, Halifax, Nova Scotia.
Archives of Physical Medicine and Rehabilitation
|December 1, 1993
Summary
Peripheral vascular disease (PVD) patients undergoing lower-extremity amputation often exhibit cognitive deficits. These impairments in psychomotor speed and abstract reasoning may stem from associated cerebrovascular disease.
Area of Science:
- Neuroscience
- Vascular Medicine
- Rehabilitation Psychology
Background:
- Peripheral vascular disease (PVD) is a leading cause of lower-extremity amputations, affecting approximately 75% of cases.
- Risk factors for PVD, such as diabetes and hyperlipidemia, are also associated with cerebrovascular disease, potentially impacting patient rehabilitation.
- Cognitive function in amputees with PVD remains an understudied area, despite its implications for recovery and quality of life.
Purpose of the Study:
- To investigate the presence and nature of cognitive deficits in patients with lower-extremity amputations secondary to PVD.
- To compare the cognitive performance of PVD amputees with that of age- and education-matched healthy controls.
Main Methods:
- A cohort of 14 lower-extremity amputees with PVD and 14 healthy controls underwent comprehensive neuropsychological testing.
- Cognitive domains assessed included memory, learning, language, praxis, visuospatial skills, and abstract reasoning.
- Standardized tests such as the Wechsler Adult Intelligence Scale-Revised Digit Symbol and the Modified Card Sorting Test were utilized.
Main Results:
- PVD patients demonstrated significantly poorer performance in psychomotor speed and abstract reasoning compared to controls (p < .002).
- Trends indicated deficits in oral fluency, concentration, reasoning, and visuoperceptual skills (p < .01).
- These findings suggest a pattern of cognitive impairment associated with PVD in amputee patients.
Conclusions:
- Cognitive deficits, particularly in psychomotor speed and abstract reasoning, are prevalent in amputees with PVD.
- These deficits may be linked to underlying, potentially unrecognized, cerebrovascular disease, indicative of a generalized vascular pathology.
- Further research is recommended to explore affective factors and identify specific etiologic or demographic correlates of these neuropsychological deficits.