Abstract Details

Title Screening for Cognitive Impairment in People with Multiple Sclerosis: Is A Unidimensional Measure Really Sufficient to Detect the Cognitive Elephant in the Room?

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-010

Objective To explore the cognitive information obtained by use of unidimensional cognitive screening tools (SDMT) and a multi-domain computerized cognitive screening assessment battery (NeuroTrax, CAB-NT) in people with Multiple Sclerosis (PwMS).

Background

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 CI in PwMS can be disconnected from visible physical disability. 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.

Design/Methods Retrospective review of consecutive PwMS referred for screening with multi-domain CAB-NT 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).

Conclusions 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.

Authors/Disclosures
Mark Gudesblatt, MD (South Shore Neurology Assoc. PC) PRESENTER	The institution of Dr. Gudesblatt has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for genentech. The institution of Dr. Gudesblatt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.
Jared Srinivasan	No disclosure on file
Myassar Zarif	Myassar Zarif has nothing to disclose.
Barbara Bumstead, NP	Ms. Bumstead has nothing to disclose.
Marijean Buhse (Stony Brook University)	Marijean Buhse has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
	No disclosure on file
Daniel Golan, MD (Carmel Medical Center)	No disclosure on file
Cynthia L. Sullivan, PhD (Neuropsychology Associates of Fairfax)	No disclosure on file
Jeffrey A. Wilken, PhD (NAF)	No disclosure on file
Glen M. Doniger, PhD (NeuroTrax Israel Ltd.)	No disclosure on file

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