Cognitive Decline in Older People with Multiple Sclerosis—A Narrative Review of the Literature

Chiang, Hsueh-Sheng; Khera, Alka; Stopschinski, Barbara E.; Stüve, Olaf; Hart, John; Kelley, Brendan J.; Nguyen, Trung

doi:10.3390/geriatrics7030061

Cited by 3 publications

(1 citation statement)

References 105 publications

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“…Whereas persons with PSI have disabling cognitive complaints as early as their 30s ( Staff et al, 2009 ), age-related MCI follows a more indolent course and usually affects individuals in their 50s or later ( Benedict et al, 2020 ). A recent review of the literature suggested that, compared to age-related MCI, MS-related impairments involve reduced processing speed but superior memory, executive, and language functions ( Chiang et al, 2022 ). In terms of neuroimaging findings, persons with age-related MCI in MS have a similar pattern of atherosclerotic cerebral small vessel disease to persons with MCI but without MS ( DeLuca et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Age and asymmetry of corticospinal excitability, but not cardiorespiratory fitness, predict cognitive impairments in multiple sclerosis

Snow,

Landine,

Chaves

et al. 2023

IBRO Neuroscience Reports

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Section: Introductionmentioning

confidence: 99%

Age and asymmetry of corticospinal excitability, but not cardiorespiratory fitness, predict cognitive impairments in multiple sclerosis

Snow,

Landine,

Chaves

et al. 2023

IBRO Neuroscience Reports

View full text Add to dashboard Cite

Depressive symptoms, anxiety and cognitive impairment: emerging evidence in multiple sclerosis

et al. 2023

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Neuropsychiatric abnormalities may be broadly divided in two categories: disorders of mood, affect, and behavior and abnormalities affecting cognition. Among these conditions, clinical depression, anxiety and neurocognitive disorders are the most common in multiple sclerosis (MS), with a substantial impact on patients’ quality of life and adherence to treatments. Such manifestations may occur from the earliest phases of the disease but become more frequent in MS patients with a progressive disease course and more severe clinical disability. Although the pathogenesis of these neuropsychiatric manifestations has not been fully defined yet, brain structural and functional abnormalities, consistently observed with magnetic resonance imaging (MRI), together with genetic and immunologic factors, have been suggested to be key players. Even though the detrimental clinical impact of such manifestations in MS patients is a matter of crucial importance, at present, they are often overlooked in the clinical setting. Moreover, the efficacy of pharmacologic and non-pharmacologic approaches for their amelioration has been poorly investigated, with the majority of studies showing marginal or no beneficial effect of different therapeutic approaches, possibly due to the presence of multiple and heterogeneous underlying pathological mechanisms and intrinsic methodological limitations. A better evaluation of these manifestations in the clinical setting and improvements in the understanding of their pathophysiology may offer the potential to develop tools for differentiating these mechanisms in individual patients and ultimately provide a principled basis for treatment selection. This review provides an updated overview regarding the pathophysiology of the most common neuropsychiatric symptoms in MS, the clinical and MRI characteristics that have been associated with mood disorders (i.e., depression and anxiety) and cognitive impairment, and the treatment approaches currently available or under investigation.

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Comparing Cognitive Profiles in Older Adults With Multiple Sclerosis and Alzheimer Disease

Hancock,

Galioto,

Rhoads

et al. 2024

Neur Clin Pract

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Background and ObjectivesUp to 65% of people with multiple sclerosis (MS) experience disease-related cognitive impairment, but even after decades of research, still very little is known about the cognitive issues among older adults with MS (EwMS; individuals aged 60+). To date, few studies have attempted to characterize cognitive impairment in this group or compare EwMS with those with other neurodegenerative diseases. Our goal was to address this knowledge gap by comparing EwMS with individuals experiencing cognitive impairment due to probable Alzheimer disease (AD) with biomarker confirmation. MethodsWe conducted an observational study of individuals seen for routine clinical care at the Cleveland Clinic. After excluding for potential confounding factors, 6 groups were assembled based on the results of their clinical workup and neuropsychological examination: cognitively normal, cognitively normal with MS, mild neurocognitive disorder (due to MS or AD), and major neurocognitive disorder (due to MS or AD). These groups were compared in terms of cognitive test performance, percentage of the group impaired on specific cognitive skills, and rates of cognitive impairment. ResultsThe sample comprised 140 individuals (64 EwMS and 76 demographically matched individuals from a memory clinic). Among those with mild neurocognitive disorder, differences between MS and AD were marked. However, in those with major neurocognitive disorder, these differences largely disappeared, except persistent performance differences on a measure of rote verbal memory. EwMS outperformed those with AD on memory tests at each level of cognitive impairment. EwMS also exhibited both subcortical and cortical deficits, rather than solely subcortical deficits.

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Cognitive Decline in Older People with Multiple Sclerosis—A Narrative Review of the Literature

Cited by 3 publications

References 105 publications

Age and asymmetry of corticospinal excitability, but not cardiorespiratory fitness, predict cognitive impairments in multiple sclerosis

Age and asymmetry of corticospinal excitability, but not cardiorespiratory fitness, predict cognitive impairments in multiple sclerosis

Depressive symptoms, anxiety and cognitive impairment: emerging evidence in multiple sclerosis

Comparing Cognitive Profiles in Older Adults With Multiple Sclerosis and Alzheimer Disease

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