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. 2020 Apr;20(4):336-342.
doi: 10.1111/ggi.13884. Epub 2020 Feb 11.

The relationship between cognition and functional outcomes in rehabilitation: FIMCog vs. MoCA

Evgeniya Zakharova-Luneva  1 , Deirdre M Cooke  1 , Satomi Okano  2 , Cameron Hurst  2 , Saul Geffen  1 , Roslyn Eagles  1
Affiliations

The relationship between cognition and functional outcomes in rehabilitation: FIMCog vs. MoCA

Evgeniya Zakharova-Luneva et al. Geriatr Gerontol Int. 2020 Apr.

Abstract

Aim: To understand the relationship between scores on two standardized measures of cognition, the Montreal Cognitive Assessment (MoCA) and the cognitive subscale of the Functional Independence Measure (FIMCog), and whether these scores can predict functional outcomes in rehabilitation.

Methods: Retrospective data analysis was conducted on all inpatients admitted to a general rehabilitation unit within a 6-month period (N = 477). The average age of patients was 74 years. The Functional Independence Measure (FIM) was completed for all patients on admission and discharge. The MoCA was administered to patients on clinical suspicion of cognitive impairment. The MoCA was completed with 116 patients. Cognitive status was assessed using FIMCog and MoCA. The motor subscale of FIM was used to assess functional status in calculating the motor Rehabilitation Functional Gain (mRFG) and motor Rehabilitation Functional Efficiency (mRFE) scores. Discharge destination was also used as an outcome measure.

Results: There was a moderate correlation between FIMCog and MoCA scores on admission (r = 0.49, P < 0.001). Higher FIMCog and MoCA scores were associated with higher mRFG and mRFE scores. There was an indication that patients with higher MoCA scores were more likely to be discharged to a private residence (adjusted odds ratio 1.11; 95% confidence interval: 0.99, 1.25, P = 0.072). Cut-off points of <25 on the MoCA (sensitivity 88.9%, specificity 48.9%), and <29 on the FIMCog (sensitivity 77.8%, specificity 53.3%) predicted those patients who were less likely to discharge to a private residence.

Conclusions: FIMCog and MoCA scores on admission were moderately correlated, and strongly correlated with functional rehabilitation outcomes. The FIMCog and MoCA had moderately high utility in predicting discharge destination. Geriatr Gerontol Int 2020; 20: 336-342.

Keywords: cognition; cognitive dysfunction; functional outcome; outcome assessment; rehabilitation.

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References

    1. Cameron ID, Kurrle SE. Rehabilitation and older people. Med J Aust 2002; 177: 387-391.
    1. Hershkovitz A, Kalandariov Z, Hermush V, Weiss R, Brill S. Factors affecting short-term rehabilitation outcomes of disabled elderly patients with proximal hip fracture. Arch Phys Med Rehabil 2007; 88: 916-921.
    1. Porte P, Lahmi K, Auque J et al. Screening of patients with cognitive impairment when entering a rehabilitation unit. Geriatr Gerontol Int 2012; 12: 23-29.
    1. Jokinen H, Melkas S, Ylikoski R et al. Post-stroke cognitive impairment is common even after successful clinical recovery. Eur J Neurol 2015; 22: 1288-1294.
    1. Puustinen J, Luostarinen L, Luostarinen M et al. The use of MoCA and other cognitive tests in evaluation of cognitive impairment in elderly patients undergoing Arthroplasty. Geriatr Orthop Surg Rehabil 2016; 7: 183-187.

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