The following is a summary of the “Cognitive impairment in people with multiple sclerosis: Perception vs. performance – factors that drive perception of impairment differ for patients and clinicians,” published in the January 2023 issue of Multiple Sclerosis and Related Disorders by Jackson, et al.
Examine whether people with MS and their doctors are able to accurately recognize the existence and degree of CI as defined by a multi-domain validated computerized test battery, and discover what factors influence the perception of CI in each group. Patients with MS took the Multi-Domain Computerized Cognitive Testing Battery, as well as the Multiple Sclerosis Impact Scale (MSIS-29), the Multiple Fatigue Impact Scale (MFIS), and the Depression Impact Scale (BDI-II).
The doctor used the EDSS to determine the patient’s level of disability (EDSS). Patients and doctors both used a Likert scale to rate the severity of their mental impairments. The accuracy of this group of PwMS in detecting attention problems (k = -.028, P =.010) was modest but statistically significant (N = 202, age range: 20 to 88, gender: 71% female). To the contrary, doctors’ accuracy in identifying global CI (k = -.037, P< .001) and a variety of particular domain impairments was moderate. Perceived cognitive impairment was substantially predicted by fatigue (P< .001) and cognitive performance (P =.012).
Several characteristics, including cognitive scores (P< .001), physical impairment (P =.011), age (P =.021), and depression (P =.038), strongly predicted clinician perceptions of cognitive performance. Patients with MS (PwMS) should undergo objective screening for CI using a multi-dimensional objective screening battery independent of patient or clinician perceptions of the presence or absence of cognitive impairments.
Source: sciencedirect.com/science/article/abs/pii/S2211034822009142