Cognition and Quality of Life of People with Spinal Cord Injury

Objectives: The aim of this study was to assess the cognitive abilities of people with spinal cord injury (SCI) using the Edinburgh Cognitive and Behavior Amyotrophic Lateral Sclerosis Screen (ECAS), a tool designed for testing cognition in individuals with limited hand motor function. The impact of cognitive dysfunction on quality of life was also assessed. Methods: Forty-one patients with SCI were assessed using ECAS, the brief version of the World Health Organisation Quality of Life questionnaire (WHOQOL-BREF), and the Spinal Cord Independence Measure. Results: Overall, 28 of the 41 participants scored below the cut-off threshold for normal population in ECAS. The domains affected were language, 63%; memory, 51%; executive function, 44%; verbal fluency, 44%; and visuospatial skills, 24%. On multiple regression analysis, the ECAS total score moderately strongly explained the variance in the WHOQOL-BREF psychological (f3 = 0.428, t = 2.958, P = 0.005) and environmental (f3 = 0.411, t = 2.819, P = 0.008) domains. ECAS memory scores independently influenced WHOQOL-BREF physical (f3 = 0.398, t = 2.67, P = 0.011) and environmental (f3 = 0.37, t = 2.697, P = 0.010) domains. WHOQOL-BREF psychological scores were significantly influenced by ECAS executive scores (f3 = 0.415, t = 2.85, P = 0.007), whereas the social domain was not significantly influenced by ECAS scores. Conclusions: It was feasible to use ECAS in individuals with SCI. Cognitive ability influenced the quality of life of people with SCI.