The Need for a Specialized Neurocognitive Screen and Consistent Cognitive Impairment Criteria in Spinal Cord Injury: Analysis of the Suitability of the Neuropsychiatry Unit Cognitive Assessment Tool

J. Clin. Med., 2022 · DOI: 10.3390/jcm11123344 · Published: June 10, 2022

Simple Explanation

This study examines the use of a cognitive assessment tool (NUCOG) for detecting mild cognitive impairment (MCI) in adults with spinal cord injury (SCI). It highlights the lack of specialized neurocognitive screens designed specifically for SCI and the inconsistent criteria used to define MCI in this population. The research assesses the NUCOG's ability to differentiate between individuals with and without MCI following SCI, considering factors like time since injury. It also explores the structural validity of the NUCOG's cognitive domains. The findings suggest that while the NUCOG can detect cognitive differences in SCI patients, its suitability for MCI assessment has limitations, indicating the need for a tailored neurocognitive screen for this population.

Study Duration

Not specified

Participants

127 adults with spinal cord injury

Evidence Level

Not specified

Key Findings

1
The NUCOG total score was sensitive to differences in neurocognitive capacity and time since injury.
2
The study found that the MCI rate varied between 17% and 36%, depending on the criteria used.
3
Confirmatory factor analysis (CFA) revealed that attention and visuoconstruction domains had adequate model fit, but executive function had poor fit, and memory and language domains did not fit the data.

Research Summary

This study evaluated the suitability of the NUCOG for assessing MCI in adults with SCI, noting the absence of SCI-specific neurocognitive screens and consistent MCI criteria. A total of 127 participants were assessed using the NUCOG, and the data were analyzed to determine the screen's sensitivity and structural validity. The results indicated that the NUCOG total score could differentiate between those with and without MCI and was sensitive to time since injury. However, confirmatory factor analysis showed that only the attention and visuoconstruction domains had acceptable structural validity. The study concludes that while the NUCOG has some utility in detecting cognitive impairment in SCI, there is a need for a specialized neurocognitive screen designed specifically for this population, along with standardized criteria for defining MCI.

Practical Implications

Development of SCI-Specific Cognitive Screen

The findings support the development of a neurocognitive screen tailored for adults with SCI to address the unique cognitive challenges and improve the accuracy of MCI detection.

Standardization of MCI Criteria

The study emphasizes the need for universally agreed-upon criteria for detecting probable MCI in SCI to allow for reliable assessment and appropriate referral for comprehensive neurocognitive assessment.

Targeted Cognitive Rehabilitation

The research suggests that a specialized test should target cognitive domains affected by SCI, such as executive functioning and attention/processing speed, to enable more effective and personalized cognitive rehabilitation strategies.

Study Limitations

1
Cross-sectional nature of the data
2
Relatively small sample size of the community participants
3
Uncertainty regarding the equivalence of 'hands-free' alternatives for items requiring upper limb motor control

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury