Contributions
Abstract: P713
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cognitive impairment (CI) is common in people with Multiple Sclerosis (PwMS). CI in PwMS impacts economically important milestones and Quality of Life. Clinician/patient perception of the presence/degree of CI is an insufficiently sensitive measure. An increasing number of cognitive domains impaired (#CDI), >1SD age and education matched in PwMS has been shown to progressively impact self-reported: driving, employment, fall risk in PwMS-EDSS< 6. Important cognitive disability in PwMS can be disconnected from visible physical disability. Due to the variability of MS plaque burden (location/degree), cognitive and physical ability might be impacted differentially. PwMS CI can potentially vary depending upon many factors. Routine cognitive screening in MS care is uncommon. SDMT, although frequently recommended, provides a single screening score that does not provide information about individual cognitive domains or the presence/degree of impairment across multiple cognitive domains or the accumulation of such CI.
Methods: Retrospective review of consecutive PwMS referred for screening with multi-domain computerized screening cognitive assessment battery (CAB) in the course of routine care who also underwent testing with the oral version of SDMT on the same day.
Results: 113 PwMS, mean age 48.9 +/- 11.3, 85% female. PwMS SDMT defined CI: 68% normal classification, 14% low, 5% moderately low, and 12% very low. Whereas multi-domain screening CAB in this same PwMS group identified CI >1SD below normal values: memory (32%), executive function (25%), attention (28%), information processing speed (30%), visual spatial processing (20%), verbal function (23%), motor skills (20%), and a global summary screening score (24%). The multi-dimensional screening CAB in this same PwMS population further identified the #CDI: 36% (#CDI-0), 24% (#CDI-1), 11.5% (#CDI-2) and 28% (#CDI-3 or more).
Conclusion: Cognitive impairment in PwMS is common. CI in PwMS can vary in presence/degree in a manner that is neither identified nor quantified by SDMT. A unidimensional score/measure is insufficient to adequately identify/appreciate the richness/variation of the combinations/degrees of CI that occurs in PwMS and impacts the appearance of meaningful CI related disability. Better screening tools than a unidimensional measure are required for evaluation of CI in PwMS.
Disclosure: JS: Nothing to disclose
LF: Nothing to disclose
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
MB: Nothing to disclose
DG: Nothing to disclose
CS: Nothing to disclose
JW: Nothing to disclose
GD: Nothing to disclose
Abstract: P713
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cognitive impairment (CI) is common in people with Multiple Sclerosis (PwMS). CI in PwMS impacts economically important milestones and Quality of Life. Clinician/patient perception of the presence/degree of CI is an insufficiently sensitive measure. An increasing number of cognitive domains impaired (#CDI), >1SD age and education matched in PwMS has been shown to progressively impact self-reported: driving, employment, fall risk in PwMS-EDSS< 6. Important cognitive disability in PwMS can be disconnected from visible physical disability. Due to the variability of MS plaque burden (location/degree), cognitive and physical ability might be impacted differentially. PwMS CI can potentially vary depending upon many factors. Routine cognitive screening in MS care is uncommon. SDMT, although frequently recommended, provides a single screening score that does not provide information about individual cognitive domains or the presence/degree of impairment across multiple cognitive domains or the accumulation of such CI.
Methods: Retrospective review of consecutive PwMS referred for screening with multi-domain computerized screening cognitive assessment battery (CAB) in the course of routine care who also underwent testing with the oral version of SDMT on the same day.
Results: 113 PwMS, mean age 48.9 +/- 11.3, 85% female. PwMS SDMT defined CI: 68% normal classification, 14% low, 5% moderately low, and 12% very low. Whereas multi-domain screening CAB in this same PwMS group identified CI >1SD below normal values: memory (32%), executive function (25%), attention (28%), information processing speed (30%), visual spatial processing (20%), verbal function (23%), motor skills (20%), and a global summary screening score (24%). The multi-dimensional screening CAB in this same PwMS population further identified the #CDI: 36% (#CDI-0), 24% (#CDI-1), 11.5% (#CDI-2) and 28% (#CDI-3 or more).
Conclusion: Cognitive impairment in PwMS is common. CI in PwMS can vary in presence/degree in a manner that is neither identified nor quantified by SDMT. A unidimensional score/measure is insufficient to adequately identify/appreciate the richness/variation of the combinations/degrees of CI that occurs in PwMS and impacts the appearance of meaningful CI related disability. Better screening tools than a unidimensional measure are required for evaluation of CI in PwMS.
Disclosure: JS: Nothing to disclose
LF: Nothing to disclose
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
MB: Nothing to disclose
DG: Nothing to disclose
CS: Nothing to disclose
JW: Nothing to disclose
GD: Nothing to disclose