The interplay between physical, cognitive, and mental health in post-intensive care syndrome: a longitudinal analysis

4 February 2025

A recent study published in Critical Care Medicine offers a detailed analysis of how physical, cognitive, and mental health impairments in post-intensive care syndrome (PICS) affect health-related quality of life (HRQoL). Conducted as a multicenter longitudinal cohort study across seven Dutch medical centers, this research sheds light on the interconnected nature of these health domains in ICU survivors.

PICS encompasses a range of health issues that persist after discharge from the intensive care unit (ICU), including physical impairments (e.g., muscle weakness, fatigue), cognitive dysfunction (e.g., memory deficits, impaired executive function), and mental health disorders (e.g., anxiety, depression, PTSD). These complications can significantly impact long-term functional status and quality of life, highlighting the need for targeted post-ICU rehabilitation strategies.

The study included 4,092 adult patients admitted to seven Dutch ICUs from 2017 to 2020 who survived hospitalization and completed assessments at ICU admission, 3 months post-discharge, and 12 months post-discharge. Standardized questionnaires were used to measure physical, cognitive, and mental health impairments and their association with HRQoL. A composite score provided a multidimensional view of post-ICU morbidity.

The study found that PICS symptoms in the physical, cognitive, and mental domains are all significantly associated with declines in long-term HRQoL. Mental health symptoms had the largest impact on HRQoL, followed by physical and cognitive symptoms.

Clinical Implications and Future Directions

These findings underscore the importance of a multidisciplinary approach to ICU aftercare, integrating physical rehabilitation, cognitive therapy, and psychological support. Future research should aim to identify early predictors of PICS to enable targeted interventions and evaluate the effectiveness of structured post-ICU rehabilitation programs.

About the publication

Tilburgs, Bram RN, PhD1; Simons, Koen S. MD, PhD2; Corsten, Stijn MD3; Westerhof, Brigitte MD4; Rettig, Thijs C. D. MD, PhD5; Ewalds, Esther MD6; Zegers, Marieke PhD1; van den Boogaard, Mark RN, PhD1. Associations Between Physical, Cognitive, and Mental Health Domains of Post-Intensive Care Syndrome and Quality of Life: A Longitudinal Multicenter Cohort Study. Critical Care Medicine 53(1):p e74-e86, January 2025. | DOI: 10.1097/CCM.0000000000006461