Assessment of cognitive difficulties and depression in a cohort of Sri Lankan patients diagnosed with clinically and radiologically definite multiple sclerosis: A cross sectional descriptive study

Abstract

Multiple sclerosis (MS) is an immune mediated demyelinating disease.Cognitive impairment in MS is known to occur in 40%–65%. It mainly involves complex attention, information processing speed and executive functions. This study analyzes the level of cognitive deficiency, prevalence of depression and their association with disease severity in a cohort of Sri Lankan MS patients. To assess level of cognitive difficulties and depression in Sri Lankan MS patients and to describe the effects of socio-demographic characteristics. Also to assess whether these parameters are affected by disease severity, duration, and number of relapses and level of motor disability. 82 confirmed MS patients (McDonald 2010, MAGNIMS 2016) attending a dedicated MS clinic at the National Hospital of Sri Lanka were randomly using direct interviews and patient registries. They were seronegative for AQP4&MOG. MMSE, MoCA and Becks depression scale (validated versions) were used for data collection. Mean age at diagnosis was 29 years with 61.4% females. At evaluation average age was 35 with an average disease duration of 6 years. 63.9% had cognitive impairment and 49.4% had some degree of depression, 3.6% severe, 14.5% moderate and 30.1% mild. 50.9% of cognitively impaired patients were also depressed. Significant association noted between cognitive impairment and TTFR (Time To First relapse) with p value of 0.045 (p < 0.05) and depression and duration of diagnosis (p = 0.02). Cognition and depression were not significantly associated (p = 0.88). Cognitive impairment and depression significantly affect South Asian MS populations.