Validity and sensitivity of Canadian normative data for the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) battery

Abstract

BackgroundCanada is amongst the countries with the highest rates of multiple sclerosis (MS). Given cognitive deficits can occur in up to 70% of individuals with MS, there is a need for Canadian normative data that allows clinicians and researchers to evaluate cognitive impairment. Discrete and regression-based Canadian normative data for the Minimal Assessment of Cognitive Function in MS (MACFIMS) was recently published. The current study sought to evaluate the discriminant and predictive ability of these norms in a Canadian MS sample. Methods188 individuals with a confirmed diagnosis of MS and 174 matched healthy controls completed all, or some, of the MACFIMS battery. ResultsIndividuals with MS performed worse than healthy controls on most MACFIMS measures to a significant degree. Similarly, a greater frequency of impairment was also observed on each measure in the MS group. When defining global impairment as ≤ – 1.5 standard deviations below the mean on at least 2 or more tests, the MACFIMS battery identified cognitive impairment in 41.49% of the Canadian MS sample. Area under the curve analyses showed acceptable discriminatory ability for most of the measures. No difference in the sensitivity at detecting cognitive impairment was observed when comparing the discrete vs. the regression-based Canadian norms. ConclusionThe MACFIMS was able to detect cognitive impairment in a Canadian MS sample and can discriminate between individuals with MS and healthy controls when using Canadian norms. The validation of these norms will allow clinicians and researchers to evaluate cognitive impairment using more culturally-appropriate comparisons for Canadians living with MS.