title: Cognitive problems in patients in a cardiac rehabilitation program after an out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  Estimate prevalence of cognitive problems due to hypoxic brain injury in out-of-hospital cardiac arrest (OHCA) survivors referred for cardiac rehabilitation and association with quality of life as well as autonomy and participation.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Consecutive OHCA patients. The Mini-Mental State Examination (MMSE), Cognitive Failures Questionnaire (CFQ) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were administered 4 weeks after the OHCA. Cognitive problems were defined if MMSE <28, CFQ >32 or IQCODE >3.6. The Impact on Participation and Autonomy Questionnaire (IPAQ) (participation/autonomy), the SF-36 Health Survey (SF-36) (quality of life) and the Hospital Anxiety Depression Scale (HADS) (anxiety/depression) were administered. Correlations between cognitive problems and participation/autonomy and quality of life were calculated.
  
  
  RESULTS
  63 of 77 patients were male (82%), median age 59 years (range 15-84). MMSE median 29 (interquartile range 28-30), CFQ mean 20.9 (SD 9.4) and IQCODE mean 3.1 (SD 0.2). Eighteen patients (23%) scored positive for cognitive problems. Significant correlations were found between MMSE and IPAQ: autonomy inside (r = -0.38), family role (r = -0.26), autonomy outside (r = -0.32), social relations (r = -0.38) and social functioning (r = 0.32). MMSE was related to SF-36: social functioning (r = 0.32). The CFQ was related to IPAQ: autonomy outdoors (r = 0.29) and SF-36: bodily pain (r = -0.37), vitality (r = -0.25), mental health (r = -0.35) and role emotional (r = -0.40). The IQCODE was related to IPAQ: autonomy indoors (r = 0.26) and to SF-36: vitality (r = -0.33) and social functioning (r = -0.41).
  
  
  CONCLUSIONS
  Twenty-three percent of the patients referred for cardiac rehabilitation showed cognitive problems. Associations were found between cognitive problems and several aspects of participation/autonomy and perceived quality of life.
authors.affiliation: Rijnlands Rehabilitation Centre, Leiden, The Netherlands. Electronic address: lww@rrc.nl.
authors.forename: L W
authors.initials: LW
authors.lastname: Boyce-van der Wal
authors.affiliation: Rijnlands Rehabilitation Centre, Leiden, The Netherlands.
authors.forename: W G
authors.initials: WG
authors.lastname: Volker
authors.affiliation: Rijnlands Rehabilitation Centre, Leiden, The Netherlands; Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, The Netherlands.
authors.forename: T P M
authors.initials: TP
authors.lastname: Vliet Vlieland
authors.affiliation: Rijnlands Rehabilitation Centre, Leiden, The Netherlands; Division Health, Medical and Neuropsychology, Faculty of Social and Behavioural Science, Leiden University, The Netherlands.
authors.forename: D M J
authors.initials: DM
authors.lastname: van den Heuvel
authors.affiliation: Rijnlands Rehabilitation Centre, Leiden, The Netherlands; Department of Cardiology, Leiden University Medical Center, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: van Exel
authors.affiliation: Rijnlands Rehabilitation Centre, Leiden, The Netherlands; Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, The Netherlands.
authors.forename: P H
authors.initials: PH
authors.lastname: Goossens
mesh_terms: D000203:Activities of Daily Living; D001526:Behavioral Symptoms / Q000175:diagnosis*; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications*; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000534:rehabilitation / Q000628:therapy; D011788:Quality of Life; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Cognitive disorders; Cognitive screening; Out-of-hospital cardiac arrest; Rehabilitation