Correlation between subjective and objective cognitive function in post-intensive care patients: a dual-center prospective cohort study

Rens W J Kooken, Søs Bohart, Arjen J C Slooter, Thordis Thomsen, Bram Tilburgs, Mark van den Boogaard

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives: To evaluate the correlation between a subjective and objective cognitive screening tool in intensive care unit (ICU) survivors three months post-discharge, and to explore differences in associated factors. Research design: Prospective cohort study. Setting: Two Dutch university ICUs. Main outcome measures: Correlation between subjective (Cognitive Failure Questionnaire [CFQ-14]) and objective (modified Telephone Interview for Cognitive Status [TICS-m]) cognitive function scores and associated clinical and demographic factors. Results: Among 372 included patients (July 2020-July 2022), 20.1 % (n = 75) had cognitive impairment (based only on a CFQ-14 score ≥43, n = 19 (5.1 %); based only on a TICS-m score ≤33, n = 52 (13.9 %); meeting both criteria, n = 4 (1.1 %)). CFQ-14 and TICS-m scores were weakly correlated (r = −0.11, p = 0.03). Using multivariable linear regression, depression scores (Hospital Anxiety and Depression Scale) were significantly associated with standardized CFQ-14 scores (adjusted β 0.16; 95%CI 0.09–0.24; p < 0.01), whereas age (adjusted β −0.03; 95%CI −0.04–−0.01; p < 0.01) and sedation-induced coma (adjusted β −0.49; 95%CI −0.91–−0.07; p = 0.02) were significantly associated with standardized TICS-m scores. Conclusion: Subjective cognitive complaints do not reliably correspond with objective cognitive impairment, and vice versa. Depression scores were associated with subjective cognition, whereas age and sedation-induced coma were associated with objective cognition. Implication for clinical practice: Nurses and physicians, particularly in post-ICU clinics, should be mindful that subjective and objective cognitive screening tools, although both valuable, adress different aspects and should not be considered interchangeable. Self-reported cognitive problems may be driven by emotional distress (e.g., depressive symptoms) rather than objective cognitive impairment.

Original languageEnglish
Article number104081
JournalIntensive and Critical Care Nursing
Volume89
Early online date29 May 2025
DOIs
Publication statusE-pub ahead of print - 29 May 2025

Keywords

  • Cognition
  • Intensive Care Units
  • Neuropsychological Tests
  • Patient Reported Outcome Measures
  • Post-intensive care syndrome

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