Cognitive and physical impairment in spinal cord injury: A scoping review and call for new understanding

Abstract

Study Design: Scoping review.

Objective: To examine potential underlying mechanisms of cognitive and physical impairment in patients with spinal cord injury and identify current research gaps.

Methods: A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews to identify primary studies that explored mechanisms of cognitive and/or physical impairment after spinal cord injury. The databases searched were PubMed/MEDLINE, EMBASE (OVID), Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO), Web of Science, Scopus, and PsycInfo. These databases were searched from inception through December 20, 2021.

Results: Accumulating research suggests that neuroinflammation and neurodegeneration after a traumatic event may be possible mechanisms for cognitive impairment among patients with SCI. In addition, lack of physical activity due to impaired mobility is associated with an increased risk of cognitive impairment.

Conclusion: While the results establish a foundation for understanding how cognitive impairment, mental health, and physical function independently affect patients with SCI, further research is warranted to understand how these factors systemically impact the patient and discover refined targets for future rehabilitation therapies. Studies should also explore potential predisposing factors for the relationship between cognitive and physical impairment among patients with SCI.

Key words:

• Cognitive impairment
• Physical decline
• Spinal cord injury
• Cognitive frailty

Acknowledgements

This work is a result of the primary author's award from the Governance Board of the Academy of Spinal Cord Injury Professionals (ASCIP) Audrey Nelson Lecture Award in 2020. We thank Christopher Bickel, BA, for the artistic interpretation provided for the conceptual framework of cognitive frailty in patients with spinal cord injury.

Disclaimer statements

Contributions None.

Funding None.

Conflicts of interest Authors have no conflict of interests to declare.