Screening for Cognitive Impairment in Multiple Sclerosis

Beatty, William W.

doi:10.1001/archneur.1990.00530030069018

Cited by 169 publications

(26 citation statements)

References 23 publications

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“…The MMSE’s lack of ability to assess individual domains and its poor sensitivity to mild cognitive impairments are frequently cited limitations [59, 60] This is because most healthy individuals can successfully answer most of the test items. Even though more demanding tests are available [25, 36, 60, 61], the MMSE still remains the most widely used and cited test of global cognition.…”

Section: Discussionmentioning

confidence: 99%

Cognitive function in a general population of men and women: a cross sectional study in the European Investigation of Cancer–Norfolk cohort (EPIC-Norfolk)

et al. 2014

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BackgroundAlthough ageing is strongly associated with cognitive decline, a wide range of cognitive ability is observed in older populations with varying rates of change across different cognitive domains.MethodsCognitive function was measured as part of the third health examination of the European Prospective Investigation of Cancer in Norfolk (EPIC-Norfolk 3) between 2006 and 2011 (including measures from the pilot phase from 2004 to 2006). This was done using a battery consisting of seven previously validated cognitive function tests assessing both global function and specific domains. The battery included a shortened version of the Extended Mental State Exam (SF-EMSE); letter cancellation task; Hopkins Verbal Learning Test (HVLT); Cambridge Neuropsychological Test Automated Battery Paired Associates Learning Test (CANTAB-PAL); Visual Sensitivity Test (VST); Shortened version of the National Adult Reading Test (Short-NART) and a task to test for prospective memory. We report the distribution of cognitive function in different cognitive domains by age and sex and compare the utility of a number of assessment tests in a general population of older men and women.ResultsCognitive test data were available for 8585 men and women taking part in EPIC-Norfolk 3. Increasing age was generally associated with declining mean cognitive function, but there was a wide range observed within each age group as well as variability across different cognitive domains. Some sex differences were also observed.ConclusionDescriptive data are presented for this general population sample of older men and women. There is a wide range of cognitive performance seen in this population. Though average performance declines with age, there is large individual variability across different cognitive domains. These variations may provide insights into the determinants of cognitive function in later life.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2318-14-142) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Cognitive function in a general population of men and women: a cross sectional study in the European Investigation of Cancer–Norfolk cohort (EPIC-Norfolk)

et al. 2014

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“…The EDSS and the Cumulative Illness Rating Scale (CIRS) will be assessed by a physician at baseline and after 52 weeks [75-77]. Cognitive deficits will be assessed at baseline by the Mini Mental State Examination [78]. …”

Section: Methodsmentioning

confidence: 99%

The effectiveness of aerobic training, cognitive behavioural therapy, and energy conservation management in treating MS-related fatigue: the design of the TREFAMS-ACE programme

Beckerman

Blikman

Heine

et al. 2013

Trials

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BackgroundTREFAMS is an acronym for TReating FAtigue in Multiple Sclerosis, while ACE refers to the rehabilitation treatment methods under study, that is, Aerobic training, Cognitive behavioural therapy, and Energy conservation management. The TREFAMS-ACE research programme consists of four studies and has two main objectives: (1) to assess the effectiveness of three different rehabilitation treatment strategies in reducing fatigue and improving societal participation in patients with MS; and (2) to study the neurobiological mechanisms of action that underlie treatment effects and MS-related fatigue in general.Methods/DesignAmbulatory patients (n = 270) suffering from MS-related fatigue will be recruited to three single-blinded randomised clinical trials (RCTs). In each RCT, 90 patients will be randomly allocated to the trial-specific intervention or to a low-intensity intervention that is the same for all RCTs. This low-intensity intervention consists of three individual consultations with a specialised MS-nurse. The trial-specific interventions are Aerobic Training, Cognitive Behavioural Therapy, and Energy Conservation Management. These interventions consist of 12 individual therapist-supervised sessions with additional intervention-specific home exercises. The therapy period lasts 16 weeks. All RCTs have the same design and the same primary outcome measures: fatigue - measured with the Checklist Individual Strength, and participation - measured with the Impact on Participation and Autonomy questionnaire. Outcomes will be assessed 1 week prior to, and at 0, 8, 16, 26 and 52 weeks after randomisation. The assessors will be blinded to allocation. Pro- and anti-inflammatory cytokines in serum, salivary cortisol, physical fitness, physical activity, coping, self-efficacy, illness cognitions and other determinants will be longitudinally measured in order to study the neurobiological mechanisms of action.DiscussionThe TREFAMS-ACE programme is unique in its aim to assess the effectiveness of three rehabilitation treatments. The programme will provide important insights regarding the most effective treatment for MS-related fatigue and the mechanisms that underlie treatment response. A major strength of the programme is that the design involves three almost identical RCTs, enabling a close comparison of the treatment strategies and a strong overall meta-analysis. The results will also support clinical practice guidelines for the treatment of MS-related fatigue.Trial registrationsCurrent Controlled Trials ISRCTN69520623, ISRCTN58583714, and ISRCTN82353628

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“…Moreover, extensive batteries may not be suitable for severely impaired or poorly educated patients. On the other hand, short mental-status tests lack sensitivity [5, 6] and fail to offer a minimally detailed picture of the altered functions [7]. …”

Section: Introductionmentioning

confidence: 99%

Cognitive Dysfunction in Multiple Sclerosis: Methods and Prevalence from the GEDMA Study

Olazarán¹,

Cruz²,

Benito‐León

et al. 2008

Eur Neurol

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Background/Aims: Cognitive dysfunction is a major handicap in multiple sclerosis (MS). Its prevalence varies due to disease heterogeneity and methodological issues. A neuropsychological battery of intermediate size was designed for and explored in the screening of cognitive dysfunction in MS patients. Methods: The battery was administered to a hospital-based sample of 191 MS patients and 50 matched controls. Eleven test scores measuring verbal fluency, verbal learning, attention, calculation and visuoperceptual ability were selected on the basis of sensitivity and lack of redundancy. Two alternative approaches were compared for diagnosis of cognitive dysfunction based, firstly, on the number of failed tasks, and secondly, on a single standardized global score. Results: The approach based on the number of failed tasks discriminated better than did the global approach between patients and controls. Using a cutoff of two altered scores, a cognitive dysfunction prevalence of 34% was obtained. The score yielded after summing errors in all tests was the most frequently altered and proved particularly useful for detecting minimally impaired patients. Conclusion: The purpose-designed battery was adequate for the screening of cognitive dysfunction in MS patients. The better accuracy of the single-task approach might reflect MS heterogeneity.

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Screening for Cognitive Impairment in Multiple Sclerosis

Cited by 169 publications

References 23 publications

Cognitive function in a general population of men and women: a cross sectional study in the European Investigation of Cancer–Norfolk cohort (EPIC-Norfolk)

Cognitive function in a general population of men and women: a cross sectional study in the European Investigation of Cancer–Norfolk cohort (EPIC-Norfolk)

The effectiveness of aerobic training, cognitive behavioural therapy, and energy conservation management in treating MS-related fatigue: the design of the TREFAMS-ACE programme

Cognitive Dysfunction in Multiple Sclerosis: Methods and Prevalence from the GEDMA Study

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