Spinal cord injuries can be caused by trauma such as a motor vehicle accident or a fall from a ladder. They can also have a medical cause, such as tumours or infections or even a severely herniated disk, that presses on the spinal cord. At Pacific Medical Law, we see people who have experienced a delay in the diagnosis and treatment of these medical conditions and we know that the results can be catastrophic.
A spinal cord injury can cause both physical and psychological disability, and although some researchers have reported that patients with a spinal cord injury have a decrease in their cognitive function – ability to take in and process information – not much is known about what causes that decrease. Is it due to the spinal cord injury itself, or are there other contributing factors? Does it make a difference at what level of the spine the injury occurred? Is it made worse by the presence of depression, anxiety or pain? These are some of the questions a group of researchers at the University of British Columbia, in collaboration with researchers in China, tried to answer.
These authors reviewed the medical literature between 1946 and 2018 that looked at the relationship between spinal cord injuries and cognitive function.
Decreased Cognitive Function Tests were Inconclusive
Although seventy studies were included in this review, the researchers were unable to draw concrete conclusions about the cause of decreased cognitive function in people with spinal cord injuries. They suggest this is largely due to the variability across the studies in not only how cognitive functioning was tested, but also the characteristics of the people enrolled in the study.
What is clear, however, is that people who have suffered a spinal cord injury have to learn new skills – new ways to walk, new ways to take care of themselves, and new ways to interact with the world. Learning these skills can be challenging if one is also cognitively impaired. This emphasizes the need for patient education, rehab and training programs to be tailored to the individual.
The researchers also highlight that spinal cord injuries have a significant impact on family members, caregivers and even rehabilitation staff. Family members should be educated about the psychological and cognitive effects of a spinal cord injury. Having realistic expectations can lower stress levels for family members and staff.
Improvements in medical and surgical care have increased the survival rate in people with spinal cord injuries. In the 1940s, the survival rate was only 10 – 20%. Today, 90% of people with a spinal cord injury survive past the first year of injury and nearly 50% survive for 40 years after their injury. The studies demonstrate that nearly two-thirds of people with spinal cord injuries have some degree of cognitive impairment. These statistics really emphasis the researchers’ findings – that spinal cord injuries affect more than just mobility – they also affect cognitive functioning. Rehab programs need to recognize this reality and be modified to improve the learning and rehab potential of the person suffering a spinal cord injury.
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