Validity and Reliability of Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Indonesia and the Correlation with Quality of Life.

Riwanti Estiasari,Syarli Melani,David Pangeran,Yuhyi Fajrina,Kartika Maharani,Freddy Sitorus,Diatri Nari Lastri,Darma Imran

doi:10.1155/2019/4290352

Abstract

Introduction Multiple Sclerosis (MS) can affect cognitive function that might interfere with quality of life. Processing speed and memory are the most common area of cognitive impairment. Cognitive evaluation in daily practice is often difficult to be performed since it needs neuropsychological expert and is time-consuming. Brief International Cognitive Assessment for MS (BICAMS) is valid and practical for cognitive evaluation. This study aims to validate BICAMS in Indonesian MS patients and healthy controls (HC) and to analyse the effect of cognitive impairment on quality of life. Methods BICAMS, which composes Symbol Digits Modalities Test (SDMT), California Verbal Learning Test-Second Edition (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R), was translated and cross-culturally adapted to Indonesian from the original BICAMS and then administered to 40 Indonesian MS patients and 66 HC matched by sex, age, and education. Test-retest reliability was performed on 16-MS patients and 42 HC. Quality of life was measured using Multiple Sclerosis Quality of Life (MSQOL-54) instrument. Results The SDMT, CVLT-II, and BVMT-R score in MS patients were significantly lower than those in HC (effect size, r: 0.61, 0.36, and 0.47, respectively). Test-retest reliability for all tests was satisfactory with correlation coefficient for SDMT, CVLT-II, and BVMT-R in MS subjects 0.86, 0.81, and 0.83, respectively. Using 5th percentile of HC score as cut-off, 15% MS subjects had impairment in one test, 27.5% in two tests, and 40% in three tests. BICAMS was moderately correlated with EDSS but was not correlated with disease duration and relapse rate. SDMT score correlated with physical function and physical and mental role limitation. Conclusion BICAMS is valid and reliable for assessing cognitive function of Indonesia MS patients.

Highlights

Multiple Sclerosis (MS) can affect cognitive function that might interfere with quality of life
healthy controls (HC) were recruited from population around our clinics, relatives, or friends of MS patients that were not affected with MS and fulfilled the same criteria
There was no significant difference in sex, age, and education duration between MS and HC groups (Table 1)

Summary

Introduction

Multiple Sclerosis (MS) can affect cognitive function that might interfere with quality of life. This study aims to validate BICAMS in Indonesian MS patients and healthy controls (HC) and to analyse the effect of cognitive impairment on quality of life. MS mostly affects young adult which typically begins at 20-40 years old It is more prevalent in female compared to man. Cognitive impairment can affect physical independence and medication adherence [3] It is detected in 41% MS patients, of which 28% experience significant decline in 5 years [4]. Deficit in processing speed [5] and memory [6, 7] are the most common cognitive impairment in MS and more prevalent in progressive type than relapsing-remitting MS (RRMS) [8]. The deficit can be detected in the early onset of MS (clinically isolated syndrome, CIS) [9]

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Conclusion