Cognitive functioning, mental health, and quality of life in ICU survivors: an overview.

The significant and sometimes permanent effects of critical illness on wide-ranging aspects of functioning are increasingly recognized. Among the areas affected are acute and long-term cognitive functioning, depression, anxiety, PTSD, and quality of life. These and other areas are increasingly being studied and indeed are increasingly the focus of clinical attention and investigations. These conditions have been a focus of attention for more than a dozen years, with much improvement occurring in the ability to characterize these phenomena. For instance, in intervening years, it has been learned that cognitive impairment is highly prevalent and functionally disruptive and that it occurs in wide-ranging domains. Key questions remain unanswered with regard to vital questions such as determining causes, risk factors, and mechanisms as well as the degree to which brain injuries associated with critical illness are amenable to rehabilitation. Little remains known about the effects of critical illness on elderly ICU cohorts and on the neurologic functioning of individuals with preexisting impairment versus those who are normal. Few data exist regarding the development of strategies designed to prevent the emergence of neuropsychological deficits after critical illness. Although great progress has been made and is ongoing, a pressing need exists for additional investigation of cognitive impairment and other conditions,such as PTSD and quality of life after critical illness, that will seek to untangle the many pertinent questions related to this condition and that will ultimately offer help and hope to the thousands of survivors affected by this condition.