Abstract

Survivors of critical illness have a high prevalence of long-term cognitive and psychiatric morbidity and poor quality of life years after hospital discharge. Data are lacking regarding whether cognitive screening tests predict which critically ill patients may be at risk to develop long-term cognitive sequelae and whether cognitive sequelae predict the patients everyday functioning. This study sought to determine whether cognitive screening tests, including the Mini-Mental State Examination (MMSE) and Mini-Cog, predict long-term cognitive sequelae and everyday functioning in survivors of critical illness 6-month post-hospital discharge. A second purpose was to investigate whether cognitive sequelae are associated with poor everyday functioning in critically ill survivors. Finally, the relationship between cognitive sequelae and quality of life was assessed. Survivors of critical illness had a high rate of cognitive impairments at hospital discharge, as well as long-term cognitive and psychiatric sequelae, deficits in everyday functioning, and reduced quality of life at 6-month follow-up. The MMSE and Mini- Cog did not predict long-term cognitive sequelae or everyday functioning at 6-months. Cognitive sequelae were not associated with poor everyday functioning; however, impaired attention, memory, and mental processing speed predicted problems with managing home/transportation, and impaired attention predicted problems in health and safety, social adjustment, and memory/orientation. Cognitive sequelae were associated with reduced quality of life in the role physical domain. Altogether, these findings lend additional knowledge to the literature regarding cognitive and psychiatric sequelae, everyday functioning, and reduced quality of life in critically ill patients, and may have clinical implications for the critical care providers, patients, and caregivers. Given the large population of survivors of critical illness each year, strategies aimed at recognizing, preventing and treating these morbidities are important research and public health concerns. Investigations into the clinical and economic burden of these morbidities and methods to mitigate them, including patient screening and referral to appropriate mental health and rehabilitation services, are warranted.

Degree

PhD

College and Department

Family, Home, and Social Sciences; Psychology

Rights

http://lib.byu.edu/about/copyright/

Date Submitted

2010-06-01

Document Type

Dissertation

Handle

http://hdl.lib.byu.edu/1877/etd3607

Keywords

Cognitive sequelae, depression, everyday functioning, critical illness, psychiatric disorders, quality of life

Included in

Psychology Commons

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