Article

OBJECTIVES: To determine the association between unique domains of cognitive
impairment and community integration in individuals with multiple sclerosis (MS),
and to determine the contributions of cognitive impairment to community
integration beyond the influence of demographic and clinical variables. DESIGN:
Cross-sectional analysis of objective neuropsychological assessment and
self-report data. Data were collected during baseline assessment of a randomized,
multisite controlled trial of ginkgo biloba for cognitive impairment in MS.
Hierarchical regression analyses examined the association between subjective and
objective measures of cognitive impairment and 3 domains of community
integration, adjusting for relevant covariates. SETTING: Two Veterans Affairs
medical center MS clinics. PARTICIPANTS: Adults (N=121; ages 24-65y) with a
confirmed MS diagnosis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Primary outcomes were scores on the Home Integration (CIQ-H), Social Integration
(CIQ-S), and Productivity (CIQ-P) domains of the Community Integration
Questionnaire (CIQ). RESULTS: Cognitive impairment was associated with lower
scores on the CIQ-H and CIQ-S, but not the CIQ-P. Greater levels of subjective
cognitive impairment were associated with lower scores on the CIQ-H and CIQ-S.
Greater levels of objective cognitive impairment, specifically slower processing
speed and poorer inhibitory control, were related to lower CIQ-S scores.
Subjective and objective measures of cognitive impairment were significantly and
independently associated with CIQ-S. CONCLUSIONS:
Objective cognitive impairment
may interfere with participation in social activities. Subjective cognitive
impairment is also important to assess, because individuals who perceive
themselves to be cognitively impaired may be less likely to participate in both
home and social activities. Clinical interventions to enhance community
integration in individuals with MS may benefit from addressing objective and
subjective cognitive impairment by integrating cognitive rehabilitation
approaches with self-efficacy-enhancing strategies.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS