Self-Reported Cognitive Concerns in People With Lower Limb Loss

Arch Phys Med Rehabil. 2016 Jun;97(6):912-8. doi: 10.1016/j.apmr.2016.01.010. Epub 2016 Feb 1.


Objectives: 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.

Design: Survey.

Setting: General community.

Participants: A volunteer sample of persons with LLL (N=1086) resulting from trauma or dysvascular complications who regularly use a prosthetic limb.

Interventions: Not applicable.

Main outcome measure: 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.

Results: 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).

Conclusions: 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.

Keywords: Amputation; Artificial limbs; Cognition disorders; Patient outcome assessment; Rehabilitation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Amputees / psychology*
  • Artificial Limbs
  • Brain Injuries, Traumatic / epidemiology
  • Cognition Disorders / epidemiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lower Extremity*
  • Male
  • Middle Aged
  • Quality of Life*
  • Self Report
  • Sex Factors
  • Socioeconomic Factors