Cognitive Function in Frail Older Adults With Multiple Sclerosis: An Exploratory Study Using Secondary Data Analysis

Abstract

ABSTRACT BACKGROUND: Studies addressing frailty in the context of multiple sclerosis (MS) are emergent. This study explores cognitive function in older adults with MS as a function of frailty status. METHODS: This cross-sectional study used baseline data from a feasibility randomized controlled trial of a home-based exercise program for older adults with MS. Frailty was verified using performance scores from the Short Physical Performance Battery (SPPB) and cut points available in the literature. Cognitive function was assessed using the Brief International Cognitive Assessments for Multiple Sclerosis (BICAMS). Data were analyzed using inferential statistics adopting a significance of P < .05. RESULTS: Data from 26 older adults with MS (≥60 years) were analyzed. The majority of the participants were women, and over 85% of the sample had the relapsing-remitting form of MS. Participants reported a mean of more than 20 years of disease and a moderate level of disability (Expanded Disability Status Scale score = 4). Nearly 58% of the sample was classified as frail based on SPPB scores. Univariate analysis demonstrated that frail older adults performed significantly worse (P < .05) on all 3 BICAMS tests. However, after controlling for age and disability level, only visuospatial memory remained significant between frailty groups (P = .043). CONCLUSIONS: Our findings suggest reduced cognitive function in frail older adults with MS compared with their nonfrail counterparts. This highlights the need to develop interventions to improve cognitive function and to reverse frailty for older adults with MS.