Cognitive function, quality of life, and aging: relationships in individuals with and without spinal cord injury

Background: Correlations between aging, cognitive impairment and poor quality of life (QOL) have been observed for many patient populations. Objective: The purpose of this study was to examine these correlations in individuals with and without spinal cord injury (SCI). Methods: 23 individuals with complete SCI and 20 individuals without SCI (NON) underwent assessment of cognitive function via the NIH Toolbox for Neurological and Behavioral Function. Participants self-rated QOL via global and symptom/domain-specific measures. Results: SCI rated global QOL to be lower than NON for the EQ-5D QALY (p < .001), but not the EQ-5D VAS, which imposes no penalty for wheeled mobility. Low QOL clustered mainly in domains pertaining to physical function/symptoms. Participants with SCI reported high QOL for positive affect/well-being and resilience. Cognitive function in SCI did not differ from NON. However, strong correlations between age and cognition observed in NON (all R-2 > 0.532) were absent in SCI. Significant correlations between cognition and QOL were prevalent for NON but not for SCI. Conclusions: Dissociation of age, cognition and QOL occurred with SCI. Divergence between EQ-5D QALY and VAS suggests that individuals with SCI may recalibrate personal assessments of QOL in ways that minimize the importance of mobility impairment.

Automated summary

This study aims to investigate the correlations between aging, cognitive impairment, and quality of life (QOL) in individuals with and without spinal cord injury (SCI). The results showed that individuals with SCI had lower global QOL, particularly in domains related to physical function and symptoms, but higher QOL in positive affect/well-being and resilience. There were no significant differences in cognitive function between SCI and non-SCI individuals, but strong correlations between age and cognition were absent in SCI. Significant correlations between cognition and QOL were prevalent for non-SCI individuals but not for those with SCI.