MoCA Domain Score Analysis and Relation to Mobility Outcomes in Dysvascular Lower Extremity Amputees

Objective

To investigate the association between cognitive functioning, as measured by the Montreal Cognitive Assessment (MoCA), and functional outcomes upon discharge from prosthetic rehabilitation.

Design

Retrospective chart audit.

Setting

Rehabilitation hospital.

Participants

Consecutive admissions (N=130; mean age, 66.21±11.19y) with lower extremity amputation of dysvascular etiology.

Interventions

Not applicable.

Main Outcome Measures

Cognitive status was assessed using the MoCA. The L Test of Functional Mobility (L Test) and the 2-minute walk test were used to estimate functional mobility and walking endurance.

Results

In multivariable linear regression analysis, those who scored 2 on the visuospatial/executive functioning (out of 5) and language (out of 3) domains had statistically shorter distances walked on the 2-minute walk test than did those who scored the highest on these MoCA domains. These values were not clinically relevant. Time to complete the L Test for those who scored the lowest on the MoCA domains of visuospatial/executive functioning and delayed recall and 3 on the attention domain (out of 6) was significantly longer than that for those who scored the highest.

Conclusions

Individuals with lower extremity amputation have an increased risk of cognitive impairment related to amputation etiology. Lower levels of functioning on MoCA domains of visuospatial/executive functioning, delayed recall, and attention were shown to negatively relate to the rehabilitation outcome of functional mobility, as measured by the L Test.