Cognitive Profiles Among Individuals With Spinal Cord Injuries: Predictors and Relations With Psychological Well-being

Objectives To examine predictors of profiles of cognitive functioning among individuals receiving acute inpatient spinal cord injury (SCI) rehabilitation, as well as associations between their cognitive functioning and psychological well-being (life satisfaction and depression) 6 months after the baseline assessment. Design Prospective observational study design, with 2 assessments approximately 6 months apart. Setting A rehabilitation unit at a level 1 trauma hospital during acute SCI hospitalization and outpatient setting after discharge. Participants Individuals (N=89) with SCI. Intervention None. Main Outcome Measures Cognitive functioning (assessed by the Repeatable Battery for the Assessment of Neuropsychological Status), life satisfaction (measured by the Life Satisfaction Index A), and depressive symptoms (measured by the Patient Health Questionnaire-9). Results Latent profile analysis identified 3 classes of individuals with similar patterns of cognitive functioning: class1 (average levels of cognitive performance across all assessed domains; n=48), class 2 (average cognitive performance, except in recall and memory; n=23), and class 3 (low cognitive functioning across multiple domains of cognition; n=18). Fewer years of education, history of smoking, history of substance use other than alcohol, and greater postconcussion symptoms were associated with higher odds of classification in class 3 ( P<. 05). Six months post baseline, individuals in class 3 reported significantly lower levels of life satisfaction than individuals in class 1 (χ 2 (1)=5.86; P=. 045) and marginally higher depressive symptoms than individuals in class 2 (χ 2 (1)=5.48; P=. 057) . Conclusions The impact of impaired cognition during acute rehabilitation may persist after discharge and influence the psychological well-being of individuals with SCI. Identifying individuals with cognitive dysfunction and attending to modifiable risk factors and may help ameliorate maladjustment after SCI.