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The relationship between cognition and functional outcomes in rehabilitation : FIMCog vs. MoCA
Zakharova-Luneva, Evgeniya Cooke, Deirdre M. Okano, Satomi Hurst, Cameron Geffen, Saul Eagles, Roslyn
Zakharova-Luneva, Evgeniya
Cooke, Deirdre M.
Okano, Satomi
Hurst, Cameron
Geffen, Saul
Eagles, Roslyn
Abstract
Aim
To understand the relationship between scores on two standardized measures of cognition, the Montreal Cognitive Assessment (MoCA) and the cognitive subscale of the Functional Independence Measure (FIMCog), and whether these scores can predict functional outcomes in rehabilitation.
Methods
Retrospective data analysis was conducted on all inpatients admitted to a general rehabilitation unit within a 6-month period (N = 477). The average age of patients was 74 years. The Functional Independence Measure (FIM) was completed for all patients on admission and discharge. The MoCA was administered to patients on clinical suspicion of cognitive impairment. The MoCA was completed with 116 patients. Cognitive status was assessed using FIMCog and MoCA. The motor subscale of FIM was used to assess functional status in calculating the motor Rehabilitation Functional Gain (mRFG) and motor Rehabilitation Functional Efficiency (mRFE) scores. Discharge destination was also used as an outcome measure.
Results
There was a moderate correlation between FIMCog and MoCA scores on admission (r = 0.49, P < 0.001). Higher FIMCog and MoCA scores were associated with higher mRFG and mRFE scores. There was an indication that patients with higher MoCA scores were more likely to be discharged to a private residence (adjusted odds ratio 1.11; 95% confidence interval: 0.99, 1.25, P = 0.072). Cut-off points of <25 on the MoCA (sensitivity 88.9%, specificity 48.9%), and <29 on the FIMCog (sensitivity 77.8%, specificity 53.3%) predicted those patients who were less likely to discharge to a private residence.
Conclusions
FIMCog and MoCA scores on admission were moderately correlated, and strongly correlated with functional rehabilitation outcomes. The FIMCog and MoCA had moderately high utility in predicting discharge destination. Geriatr Gerontol Int 2020; 20: 336–342.
Keywords
cognition, cognitive dysfunction, functional outcome, outcome assessment, rehabilitation
Date
2020
Type
Journal article
Journal
Geriatrics and Gerontology International
Book
Volume
20
Issue
4
Page Range
336-342
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
Faculty of Health Sciences
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Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
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Controlled