Multiple sclerosis and quality of life: The role of cognitive impairment on quality of life in people with multiple sclerosis

Catherine Bergmann; Shenira Becker; Adreanna Watts; Cynthia Sullivan; Jeffrey Wilken; Daniel Golan; Myassar Zarif; Barbara Bumstead; MariJean Buhse; Olivia Kaczmarek; Thomas J Covey; Glen M Doniger; Iris-Katharina Penner; Laura M Hancock; Hans Bogaardt; Marissa A Barrera; Sara Morrow; Mark Gudesblatt

doi:10.1016/j.msard.2023.104966

Multiple sclerosis and quality of life: The role of cognitive impairment on quality of life in people with multiple sclerosis

Mult Scler Relat Disord. 2023 Nov:79:104966. doi: 10.1016/j.msard.2023.104966. Epub 2023 Sep 3.

Authors

Catherine Bergmann¹, Shenira Becker², Adreanna Watts³, Cynthia Sullivan⁴, Jeffrey Wilken⁴, Daniel Golan⁵, Myassar Zarif⁶, Barbara Bumstead⁶, MariJean Buhse⁷, Olivia Kaczmarek⁶, Thomas J Covey⁸, Glen M Doniger⁹, Iris-Katharina Penner¹⁰, Laura M Hancock¹¹, Hans Bogaardt¹², Marissa A Barrera¹³, Sara Morrow¹⁴, Mark Gudesblatt⁶

Affiliations

¹ Washington Neuropsychology Research Group, Fairfax, Virginia. Electronic address: cbergmann@neuropsychologyfairfax.com.
² Department of Veteran Affairs, Cedar Park, Texas, United States; Senseye, Inc., Austin, Texas, United States.
³ Washington Neuropsychology Research Group, Fairfax, Virginia.
⁴ Washington Neuropsychology Research Group, Fairfax, Virginia; Department of Neurology, Georgetown University, Washington, D.C, United States.
⁵ Multiple Sclerosis and Neuroimmunology Center, Clalit Health Services, Nazareth, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
⁶ NYU Langone South Shore Neurologic Associates, New York University, Patchogue, New York, USA.
⁷ NYU Langone South Shore Neurologic Associates, New York University, Patchogue, New York, USA; Department of Nursing, State University of Stony Brook, Stony Brook, New York, USA.
⁸ Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Sherman Hall Annex Room 114, Buffalo, NY 14214, USA; Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
⁹ Department of Clinical Research, NeuroTrax Corporation, Modiin, Israel.
¹⁰ Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
¹¹ Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.
¹² School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia.
¹³ Katz School of Science & Health, Yeshiva University, New York, NY, USA.
¹⁴ London Health Sciences Centre, University of Western Ontario, Canada.

PMID: 37690436
DOI: 10.1016/j.msard.2023.104966

Abstract

Background: Multiple Sclerosis (MS), a chronic disease of the central nervous system (CNS), affects functional ability and quality of life (QoL). Depression, fatigue, and disability status are among the many factors that have been shown to impact QoL in people with MS, but the extent to which MS-related cognitive impairment is related to QoL is understudied in the literature.

Objective: The purpose of this study was to determine relevant predictors of QoL from a wide list of symptoms including physical disability, and a multi-dimensional computerized cognitive assessment battery (CAB), depression, fatigue, and demographic variables (including employment status). In addition, the unique predictive power of cognitive impairment on QoL was explored in relation to other common factors of disease impact.

Methods: 171 people with MS (PwMS) were evaluated with a computerized assessment battery (CAB), EDSS examination, and validated Patient Reported Outcome (PRO) measures (Multiple Sclerosis Impact Scale, MSIS-29; Beck Depression Inventory - Second Edition BDI-2; and the Modified Fatigue Impact Scale, MFIS).

Results: 171 PwMS were included [Age: 46.02 years ± 9.85, 124 (72.5%) female]. Depression and fatigue scores were highly correlated with MSIS-29. EDSS, unemployment, memory, executive functioning, and motor skills were moderately correlated with MSIS-29. Predictors of QoL were EDSS, depression, fatigue, executive functioning, and attention. Attention and executive functioning were predictive of QoL even after controlling for demographic variables, fatigue, depression, and physical disability status.

Conclusion: Findings indicate the need for comprehensive and quantified evaluation of all factors associated with disease burden, which will ultimately serve to improve the QoL in PwMS through more targeted and patient-centered care.

Keywords: Cognition; Multiple sclerosis; Patients; Quality of life.

MeSH terms

Cognitive Dysfunction* / complications
Depression / psychology
Fatigue / psychology
Female
Humans
Male
Middle Aged
Multiple Sclerosis* / diagnosis
Quality of Life / psychology