Gender Differences Regarding the Impact of Change in Cognitive Function on the Functional Status of Intensive Care Unit Survivors: A Prospective Cohort Study

Abstract

Purpose This study aimed to identify gender differences with regard to the impact of change in cognitive function on functional status 3 months after receiving critical care. Design and Methods This prospective cohort study investigated 152 intensive care unit (ICU) patients. Their functional status and cognitive function were assessed using the validated Korean version of the Modified Barthel Index and Mini‐Mental State Examination, respectively. Hierarchical regression was used to evaluate the impact of change in cognitive function on functional status in ICU survivors by gender. Findings The proportion of women suffering from consistent cognitive impairment was significantly higher than that of men. Women had a rate of improvement to normal cognitive function within 3 months after discharge that was higher than that of men. Functional status 3 months after discharge was significantly lower for patients whose cognitive impairment was consistent than that for those whose cognitive function was normal. The impact of change in cognitive function on men (R2 change = .28) was greater than that on women (R2 change = .13). Conclusions Persistent cognitive impairment after critical illness had a negative effect on functional status in ICU survivors. Importantly, the negative impact of consistent cognitive impairment was greater in men than in women. Clinical Relevance Early careful assessment of functional and cognitive status after critical illness is warranted. Strategies addressing the gender‐specific characteristics related to cognitive improvement should also be developed.

Factores psicosociales en personas egresadas de unidades de cuidados intensivos: una revisión narrativa de la literatura

“…En cuanto al deterioro cognitivo, Son, et al (2020) hallaron que las mujeres tenían un deterioro cognitivo significativamente mayor que los hombres, tanto al inicio del estudio como a los tres meses del alta; sin embargo, apuntan que el deterioro cognitivo alguna una vez presente en los hombres tiene un efecto mayor en estos que en las mujeres, lo que sugiere la necesidad de indagar si el género como constructo social influye en la ocurrencia e intensidad de dicho deterioro.…”

“…A ese respecto, Son et al (2020) indican que llevar a cabo este tipo de intervenciones de forma oportuna ayuda a los pacientes a mantener un estado mental saludable tras el alta, por lo que es necesario desarrollar estrategias específicas de prevención e intervención temprana para las personas internadas a una UCI que puedan reducir el riesgo de morbilidades en su salud mental. Dijkstra-Kersten (2020) sugiere incluso el ofrecerles un seguimiento específico en función de su perfil de riesgo y de sus preferencias para personalizar el tratamiento y optimizar el uso de los recursos.…”