Disclosures: Laryssa Richards, DO: No financial relationships or conflicts of interest

Objective: Assess the rate of cognitive impairment in people admitted to Acute Comprehensive Inpatient Rehabilitation (ACIR) with new or chronic dysvascular lower limb amputations, transmetatarsal level and proximal, without a neurological admission diagnosis. Evaluate the correlation of lower limb dysvascular amputation and cognitive impairment using the MoCA and through formal SLP evaluation using the RBANS.

Design: Twenty consecutive patients admitted to ACIR with new or chronic dysvascular lower limb amputations, transmetatarsal level and proximal, without a neurological admission diagnosis underwent an MoCA exam performed by an OT. If the MoCA score was below normal (less than 26), then SLP was consulted for further cognitive assessment, including RBANS. Further SLP involvement throughout the patient’s stay in ACIR was provided as indicated and included sharing pertinent feedback to the team on how to best tailor the treatment plan.Setting : ACIRParticipants : Twenty consecutive patients admitted to ACIR with new or chronic dysvascular lower limb amputations at the transmetatarsal level or proximal without a neurological admission diagnosis

Interventions: See design, after MoCA was done by OT, SLP consultation was considered.

Main Outcome Measures: MoCA scores and RBANS scores.

Results: After running a one sample t-test on MoCA scores the resulting p-value was < 0.5. A one sample t-test was run on RBANS scores and the p-value was < 0.5.Conclusions: Factors that put people with limb loss at risk for amputation are established risk factors for cognitive impairment with significant functional implications, necessitating early coordination of care during an ACIR admission. By doing early MoCA and RBANS tests, better understanding of the deficits can help with discharge planning. This includes the facilitation and incorporation of cognitive compensatory strategies within the individualized treatment plan in order to optimize this population for successful post-amputation rehabilitation, improve safety at discharge, allow for the greatest level of independence, and decrease caregiver burden.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/cognitive-impairment-in-people-with-dysvascular-lower-limb-loss/