title: Self-Reported Cognitive Concerns in People With Lower Limb Loss.
abstract: To investigate differences between self-reported cognitive concerns in people with lower limb loss (LLL) and normative data derived from the U.S. general population, and secondarily to determine whether there were cognitive differences based on amputation etiology or age.
  
  
  
  Survey.
  
  
  
  General community.
  
  
  
  A volunteer sample of persons with LLL (N=1086) resulting from trauma or dysvascular complications who regularly use a prosthetic limb.
  
  
  
  Not applicable.
  
  
  
  The Quality of Life in Neurological Disorders Applied Cognition-General Concerns Short Form version 1.0 (Neuro-QoL ACGC), an 8-item self-report measure of general cognitive concerns.
  
  
  
  People with LLL reported significantly more cognitive concerns than the Quality of Life in Neurological Disorders normative sample. Mean Neuro-QoL ACGC scores were significantly lower than normative values (P<.001) across subgroups defined by age (ie, <40, 40-49, 50-59, 60-69, and 70+ years) and subgroups defined by etiology (ie, traumatic and dysvascular LLL). However, there were no significant differences in cognitive concerns among age subgroups (P=.84) or between the etiology subgroups (P=.58).
  
  
  
  When compared with the Quality of Life in Neurological Disorders normative sample, individuals with LLL report greater concerns with cognitive health. Cognitive concerns were not differentially affected by age or cause of amputation. The presence of cognitive concerns in people with LLL suggests a need to assess perceived cognitive function in order to tailor education and training in prosthetic use and care.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Morgan
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Valerie E
authors.initials: VE
authors.lastname: Kelly
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Amtmann
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Rana
authors.initials: R
authors.lastname: Salem
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA. Electronic address: bhafner@uw.edu.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hafner
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000674:Amputees / Q000523:psychology*; D001186:Artificial Limbs; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Amputation; Artificial limbs; Cognition disorders; Patient outcome assessment; Rehabilitation
references.citation: Clin Rehabil. 2003 Aug;17(5):493-8
references.pmid: 12952154
references.citation: Arch Phys Med Rehabil. 2006 Feb;87(2):270-7
references.pmid: 16442984
references.citation: Neurology. 2012 Jun 5;78(23):1860-7
references.pmid: 22573626
references.citation: Mult Scler. 2007 Jan;13(1):81-6
references.pmid: 17294615
references.citation: J Rehabil Res Dev. 2014;51(6):933-50
references.pmid: 25479042
references.citation: Arch Phys Med Rehabil. 2000 Aug;81(8):1039-44
references.pmid: 10943752
references.citation: Arch Phys Med Rehabil. 2001 Jun;82(6):731-4
references.pmid: 11387575
references.citation: Vasc Med. 2009 Feb;14(1):51-61
references.pmid: 19144780
references.citation: Phys Med Rehabil Clin N Am. 2014 Feb;25(1):1-8
references.pmid: 24287235
references.citation: Disabil Rehabil. 2013 Feb;35(3):221-7
references.pmid: 22686166
references.citation: Cochrane Database Syst Rev. 2011;(12):CD006380
references.pmid: 22161403
references.citation: Qual Life Res. 2012 Apr;21(3):475-86
references.pmid: 21874314
references.citation: Prosthet Orthot Int. 2012 Mar;36(1):45-52
references.pmid: 22252778
references.citation: Mayo Clin Proc. 2015 Apr;90(4):532-45
references.pmid: 25841257
references.citation: J Diabetes Complications. 2014 Nov-Dec;28(6):863-8
references.pmid: 25127250
references.citation: Qual Life Res. 2010 Jun;19(5):677-85
references.pmid: 20306332
references.citation: Lancet Neurol. 2003 Jan;2(1):15-21
references.pmid: 12849297
references.citation: J Neurol Neurosurg Psychiatry. 2006 Feb;77(2):159-65
references.pmid: 16103044
references.citation: Arch Phys Med Rehabil. 2000 Mar;81(3):292-300
references.pmid: 10724073
references.citation: PLoS One. 2012;7(4):e35087
references.pmid: 22493733
references.citation: Arch Neurol. 2001 Dec;58(12):1985-92
references.pmid: 11735772
references.citation: Arch Phys Med Rehabil. 2015 Aug;96(8):1474-83
references.pmid: 25917819
references.citation: Phys Med Rehabil Clin N Am. 2014 Feb;25(1):29-33
references.pmid: 24287237
references.citation: Consult Pharm. 2012 Jun;27(6):392-9
references.pmid: 22698546
references.citation: J Vasc Surg. 2014 May;59(5):1323-30.e1
references.pmid: 24406089
references.citation: Qual Life Res. 2014 Aug;23(6):1767-75
references.pmid: 24442531
references.citation: J Head Trauma Rehabil. 2009 Nov-Dec;24(6):430-8
references.pmid: 19940676
references.citation: Ergonomics. 2015;58(9):1471-86
references.pmid: 25855858
references.citation: Disabil Rehabil. 2012;34(23):1950-64
references.pmid: 22458350
references.citation: J Rehabil Med. 2012 Nov;44(11):968-74
references.pmid: 23037865
references.citation: Clin Interv Aging. 2014;9:1011-9
references.pmid: 25061284
references.citation: Arch Phys Med Rehabil. 2008 Mar;89(3):422-9
references.pmid: 18295618
references.citation: Drugs. 2003;63(1):17-32
references.pmid: 12487620
references.citation: J Rehabil Res Dev. 2013;50(2):161-72
references.pmid: 23760997
references.citation: Expert Rev Pharmacoecon Outcomes Res. 2004 Oct;4(5):515-23
references.pmid: 19807545