P.5.c.001 Cognitive impairment in multiple sclerosis: methods of assessment and correlation with physical disability

2011 ◽  
Vol 21 ◽  
pp. S551
Author(s):  
P. Ionescu ◽  
S. Petrescu ◽  
E. Sandu ◽  
G.D. Vanghelie ◽  
N. Munjev ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability

The association between cognitive impairment and physical disability in multiple sclerosis

2005 ◽  
Vol 11 (4) ◽  
pp. 469-476 ◽  
Author(s):  
Sharon G Lynch ◽  
Brett A Parmenter ◽  
Douglas R Denney
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Cross Sectional ◽  
Delayed Recall ◽  
Physical Decline ◽  
Disability Status ◽  
Duration Of Disease ◽  
Cross Sectional Design ◽  
The Relationship

Background: The association between cognitive impairment and physical disability was examined in a larger, more representative sample of patients with multiple sclerosis (MS) than in previous studies. Method: Two hundred and fifty-three patients attending an MS clinic were assessed with respect to physical disability using the Expanded Disability Status Scale and cognitive impairment using a battery of neuropsychological tests. Results: Physical disability correlated with duration of disease; cognitive impairment did not. Virtually all measures derived from the cognitive battery were significantly correlated with physical disability. Three measures of speeded information processing and one involving delayed recall of verbal material were unique predictors of disability status. The relationship between cognitive impairment and physical disability was equivalent for patients with shorter (<3 years) versus longer (>10 years) disease duration. Cognitive impairment correlated with the rate of disability progression as reflected by the progression index. Conclusion: Cognitive impairment is more closely associated with physical disability than most previous studies indicate. This relationship appears to be stable throughout the duration of MS, although this conclusion is qualified by the cross-sectional design of the study. Further attention should be paid to cognitive impairment as a possible predictor of the rate of patients’ physical decline.

Cognitive Impairment in Patients With Multiple Sclerosis and Mild Physical Disability

1987 ◽  
Vol 44 (5) ◽  
pp. 494-501 ◽  
Author(s):  
W. van den Burg ◽  
A. H. van Zomeren ◽  
J. M. Minderhoud ◽  
A. J. A. Prange ◽  
N. S. A. Meijer
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability

Disclosure of disease status among employed multiple sclerosis patients: Association with negative work events and accommodations

2014 ◽  
Vol 21 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Seth E Frndak ◽  
Victoria M Kordovski ◽  
Diane Cookfair ◽  
Jonathan D Rodgers ◽  
Bianca Weinstock-Guttman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Psychiatric Symptoms ◽  
Disease Status ◽  
Adaptive Strategy ◽  
Cross Sectional ◽  
Disclosure Status ◽  
Multiple Sclerosis Patients

Background: Unemployment is common in multiple sclerosis (MS) and detrimental to quality of life. Studies suggest disclosure of diagnosis is an adaptive strategy for patients. However, the role of cognitive deficits and psychiatric symptoms in disclosure are not well studied. Objective: The goals of this paper were to (a) determine clinical factors most predictive of disclosure, and (b) measure the effects of disclosure on workplace problems and accommodations in employed patients. Methods: We studied two overlapping cohorts: a cross-sectional sample ( n = 143) to determine outcomes associated with disclosure, and a longitudinal sample ( n = 103) compared at four time points over one year on reported problems and accommodations. A case study of six patients, disclosing during monitoring, was also included. Results: Disclosure was associated with greater physical disability but not cognitive impairment. Logistic regression predicting disclosure status retained physical disability, accommodations and years of employment ( p < 0.0001). Disclosed patients reported more work problems and accommodations over time. The case study revealed that reasons for disclosing are multifaceted, including connection to employer, decreased mobility and problems at work. Conclusion: Although cognitive impairment is linked to unemployment, it does not appear to inform disclosure decisions. Early disclosure may help maintain employment if followed by appropriate accommodations.

Cognitive impairment in patients with multiple sclerosis: association with the APOE gene and promoter polymorphisms

2007 ◽  
Vol 13 (1) ◽  
pp. 25-32 ◽  
Author(s):  
B A Parmenter ◽  
D R Denney ◽  
S G Lynch ◽  
L S Middleton ◽  
L M Harlan
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Neuropsychological Test ◽  
Disease Onset ◽  
Apoe Gene ◽  
Promoter Polymorphisms ◽  
Severe Cognitive Impairment ◽  
Ε4 Allele ◽  
Male Patients

Background Studies examining the ε4 allele of the APOE gene as a factor affecting the severity of multiple sclerosis (MS) have yielded conflicting results. The focus of these studies on physical disability to the neglect of cognitive impairment is surprising in light of the associations between the ε4 allele and other dementia conditions. Only two studies examine the relationship between the ε4 allele and cognitive impairment. Methods A neuropsychological test battery was administered to 263 MS patients, and their current disability status was evaluated. Genotypes were determined for APOE epsilon and for two promoter region polymorphisms (-219 G/T and -491 A/T). Results Although effects were generally weak, female patients with the -491 AA genotype had a later age of disease onset, lower disability scores, and somewhat higher scores on the cognitive battery. Male patients with the ε2 allele had lower disability and higher scores on the cognitive battery. The ε4 allele was not related to physical disability, and there was no difference between ε4+and ε4– patients in overall cognitive performance. However, when patients with severe cognitive impairment were identified, a greater proportion (52%) of these patients had the ε4 allele than those in the unimpaired group (27%). Conclusion An association with the ε4 allele was evident in this study, but only in cases of severe cognitive impairment.

Cognitive impairment in patients with multiple sclerosis using the Brief Repeatable Battery-Neuropsychology test

2006 ◽  
Vol 12 (2) ◽  
pp. 187-195 ◽  
Author(s):  
J Sepulcre ◽  
S Vanotti ◽  
R Hernández ◽  
G Sandoval ◽  
F Cáceres ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Educational Level ◽  
Physical Disability ◽  
Healthy Controls ◽  
Z Score ◽  
Disabled Patients ◽  
Repeatable Battery ◽  
And Performance ◽  
Cognitive Measurement

Aims To assess the cognitive impairment of multiple sclerosis (MS) patients using the Brief Repeatable Battery-Neuropsychology (BRB-N) test. Methods The performance of 59 patients with MS in the BRB-N test was assessed and compared with 152 matched healthy controls (HC). Results In most tests, MS patients performed worse than controls. Age and educational level strongly influenced the performance of the subjects. The Symbol Digit Modality Test (SDMT) best correlated with the other individual tests and contributed most to the general BRB-N factor. Furthermore, a correlation between physical disability and performance in some BRB-N tests was observed. Indeed, patients with progressive MS and greater physical disability performed worse in some tests than less disabled patients with relapsing MS. By creating a global BRB-N Z score, we found that patients generally performed 0.7 standard deviation (SD) below the level of controls. We obtained cut-off values stratified by age and education to determinate cognitive impairment in MS patients. Conclusions Our data show that cognitive impairment is prevalent amongst MS patients, and that a single cognitive measurement might be useful for monitoring patients during the progression of this illness.

scholarly journals Depression and Cognitive Impairment in Disability-Free Early Multiple Sclerosis

2003 ◽  
Vol 14 (1-2) ◽  
pp. 39-45 ◽  
Author(s):  
Claus G. Haase ◽  
Michael Tinnefeld ◽  
Marc Lienemann ◽  
Reinhard E. Ganz ◽  
Pedro M. Faustmann
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Neuropsychological Tests ◽  
Short Term Memory ◽  
Clinical Signs ◽  
Depression Scale ◽  
Diagnostic Tools ◽  
Disability Status ◽  
Relapsing Remitting

Cognitive and emotional capabilities were evaluated in 73 female patients with stable relapsing-remitting definite, and/or laboratory-supported multiple sclerosis (MS) and were compared with 32 matched healthy controls. Patients were categorized according to their score in the expanded disability status scale (EDSS) to either no (EDSS 0,n= 33) or few clinical signs (EDSS 1–2,n= 40) of MS without physical disability. Patients with EDSS > 0 were characterized by significantly (p These results indicate that depression may present as an early sign in MS followed by cognitive impairment, in particular visuo-spatial short-term memory, before physical disability appears. Neuropsychological tests as mentioned here could serve as early diagnostic tools to detect subtle disease progression and to initiate and monitor disease modifying therapies.Patients with EDSS > 0 were characterized by significantly (p< 0.001) higher scores on “von Zerssen’s“ depression scale, compared to controls. Patients with higher EDSS scores (1–2) showed significantly decreased performance with respect to the total score of Kimura’s Recurring-Figures-Test (p< 0.001), in addition. Regarding visuo-constructive functioning, patients with EDSS = 0 performed to a significantly lower level (p< 0.001), compared to controls.

scholarly journals The effect of self-assessed fatigue and subjective cognitive impairment on work capacity: The case of multiple sclerosis

2018 ◽  
Vol 25 (5) ◽  
pp. 740-749 ◽  
Author(s):  
Gisela Kobelt ◽  
Dawn Langdon ◽  
Linus Jönsson
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Work Capacity ◽  
Independent Effect ◽  
Subjective Cognitive Impairment ◽  
Point Increase ◽  
Working Age ◽  
Regular Work ◽  
The Impact

Objectives: The impact of physical disability in multiple sclerosis on employment is well documented but the effect of neurological symptoms has been less well studied. We investigated the independent effect of self-reported fatigue and cognitive difficulties on work. Methods: In a large European cost of illness survey, self-reported fatigue, subjective cognitive impairment (SCI), and productivity at work were assessed with visual analogue scales (VAS 0–10). The analysis controlled for country, age, age at diagnosis, gender, education, and physical disability. Results: A total of 13,796 patients were of working age and 6,598 were working. Physical disability had a powerful impact on the probability of working, as did education. The probability of working was reduced by 8.7% and 4.4% for each point increase on the VAS for SCI and fatigue, respectively ( p < 0.0001). Regular work hours decreased linearly with increasing severity of fatigue and cognitive problems, while sick leave during the 3 months preceding the assessment increased. Finally, the severity of both symptoms was associated with the level at which productivity at work was affected ( p < 0.0001). Conclusion: Our results confirm the independent contribution of self-reported fatigue and SCI on work capacity and highlight the importance of assessment in clinical practice.

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