Cognitive impairment in patients with multiple sclerosis

Abstract

Objective — to investigate the characteristics of cognitive impairment (CI) in patients with multiple sclerosis (MS) and their impact on quality of life (QoL).Methods and subjects. We studied 149 patients with MS (58 men and 91 women). The mean age of the examined patients was 36.26 ± 0.85 years, the average duration of the disease 6.99 ± 0.43 years, the average score on the EDSS disability scale was 3.19 ± 1.35. All patients underwent a comprehensive clinical and neurological examination, neuropsychological testing to determine the severity of cognitive impairments and quality of life indexes assessment. The severity of the neurological deficit was determined using the EDSS scale. The study of cognitive status was carried out using a screening minimum scale for assessing the state of mental functions (MiniMentalState Examination ((MMSE), quality of life — using the SF‑36 questionnaire. Statistical processing of the results was carried out using descriptive statistics methods. The l2 test and Fisher’s test were used to compare the categorical variables of the studied samples. To compare the mean values in two independent samples, the two‑sample Student’s t‑test was used, to analyze the clinical features in MS and their effect on QoL indicators we applied correlation, variance and multiple regression analyzes, to compare the reliability of the formation of certain clinical symptoms in patients we used methods of analysis with calculation relationship of chances.Results. A quarter of the examined 38 (25.5 %) patients had mild cognitive impairments. The formation of cognitive deficit was due to such indicators as attention, memory and the ability to follow oral and written instructions. Cognitive impairments were most pronounced in patients with progressive forms of the disease and a high rate of progression with a tendency to significant deterioration with increasing degree of disability. The analysis of QoL indicators, depending on the cognitive status of patients, showed that cognitive impairments negatively affect both the physical and mental components of the QoL in MS patients.Conclusions. The results indicate the necessity of comprehensive examination of patients with MS with a mandatory assessment of the cognitive status and quality of life indicators, especially in patients with progressive forms of the disease.