Objective: To establish a comprehensive profile of cognitive
functioning in people engaged in lower limb amputation (LLA)
Design: Cross-sectional study as part of a longitudinal prospective
Setting: A national, tertiary, rehabilitation hospital.
Participants: Adult volunteer participants (N=87) referred for
comprehensive rehabilitation for major LLA were sampled from 207
consecutive admissions. Participants with both vascular (n=69) and nonvascular
(n=18) LLA aetiologies were included.
Interventions: Not applicable
Main Outcome Measure(s): Demographic and health information, and a
battery of standardised neuropsychological assessments
Results: Compared to normative data, impairment was evident in overall
cognitive functioning (p≤.003). Impairment was also evident in particular
areas, including reasoning, psychomotor function, information processing,
attention, memory, language/naming, visuospatial functions, and executive
functions (all p≤.003 Holm-corrected). There were also higher frequencies
of impaired functions across most aspects of functioning in this group,
compared to expected frequencies in normative data (p≤.003 Holmcorrected).
There were no significant differences in cognitive
functioning between participants of vascular and non-vascular LLA
Conclusions: Findings support the need for cognitive screening at
rehabilitation admission regardless of aetiology. Administration of
comprehensive neuropsychological assessment with a battery sensitive to
vascular cognitive impairment is recommended in some cases, to generate
an accurate and precise understanding of relative strengths and
weaknesses in cognitive functioning. Cognitive functioning is a potential
intervention point for improvement of rehabilitation outcomes for those
with LLA and further research is warranted in this area.