Abstract
Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published. To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals. The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized. 11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007). Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures.
Highlights
Multiple Sclerosis (MS) symptoms vary greatly, but cognitive impairment may affect 40-70% of patients[1,2,3]
Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in multiple sclerosis (MS), and lay the much needed foundation for future work that will utilize MS-validated cognitive measures
The TICS-M scores ranged from 8-36, and were normally distributed in cases and controls (Supplementary Figure 1)
Summary
Multiple Sclerosis (MS) symptoms vary greatly, but cognitive impairment may affect 40-70% of patients[1,2,3]. Full characterization of cognitive ability in MS requires psychometric assessment of CPS and memory, using tests with established validity in MS samples. These tests may be brief, but typically require a one-on-one clinical evaluation with a psychologist. This approach is not practical for large-scale clinical, genetic or epidemiologic studies, which require an abundance of information to be collected on hundreds or thousands of participants. There is no formally validated test to assess MS cognitive function remotely. Feasibility studies involving remote testing of a large number of MS patients derived from a population representative sample have not been attempted. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published
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