Utility of the Brief Assessment of Cognitive Health (BACH) computerized screening tool in identifying MS-related cognitive impairment

Karlee S Patrick; Shinjon Chakrabati; Tasha Rhoads; Robyn M Busch; Darlene P Floden; Rachel Galioto

doi:10.1016/j.msard.2023.105398

Utility of the Brief Assessment of Cognitive Health (BACH) computerized screening tool in identifying MS-related cognitive impairment

Mult Scler Relat Disord. 2024 Feb:82:105398. doi: 10.1016/j.msard.2023.105398. Epub 2023 Dec 22.

Authors

Karlee S Patrick¹, Shinjon Chakrabati², Tasha Rhoads³, Robyn M Busch⁴, Darlene P Floden⁵, Rachel Galioto³

Affiliations

¹ Department of Psychological Sciences, Kent State University, Kent, OH, United States. Electronic address: kpatri14@kent.edu.
² Department of Neurosciences, Case Western Reserve University, Cleveland, OH, United States.
³ Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States.
⁴ Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States; Epilepsy Center, Neurological Institute, Cleveland Clinic, OH, United States.
⁵ Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States; Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, OH, United States.

PMID: 38183694
PMCID: PMC10872240 (available on 2025-02-01)
DOI: 10.1016/j.msard.2023.105398

Abstract

Background: Current guidelines recommend that individuals with MS are screened annually for processing speed deficits, often using the Symbol Digit Modalities Test (SDMT). However, given the heterogeneity of cognitive deficits in individuals with MS, other screening measures that assess a range of cognitive domains are necessary. The current cross-sectional study aimed to examine the ability of the computerized, self-administered Brief Assessment of Cognitive Health (BACH) screening measure to detect the presence of cognitive impairment in adults with MS as determined by performance on a standard neuropsychological test battery.

Methods: Seventy-two individuals with MS completed the BACH and a comprehensive neuropsychological test battery. Receiver operating characteristic (ROC) analyses were conducted to investigate the ability of the BACH to identify cognitively impaired and cognitively intact individuals. ROC analyses were also conducted to compare the ability of the SDMT to discriminate between cognitively intact and cognitively impaired groups as a comparison with the BACH.

Results: Cognitive impairment was observed in 56 % of the sample. The BACH showed acceptable ability to discriminate between cognitively intact and cognitively impaired groups (AUC = 0.78). Additionally, the BACH was able to adequately predict cognitive impairment in domains other than processing speed (AUC = 0.71). The SDMT also demonstrated adequate utility in identifying individuals with cognitive impairment (AUC = 0.73); however, the SDMT was not able to adequately predict cognitive impairment in domains other than processing speed (AUC = 0.56).

Conclusion: The BACH showed adequate ability to detect cognitive impairment in individuals with MS. The BACH was able to identify impairments across various assessed cognitive domains, including individuals with and without processing speed deficits.

Keywords: Cognitive Impairment; Cognitive Screening; Multiple sclerosis; Neuropsychological assessment.

MeSH terms

Adult
Cognition
Cognition Disorders* / diagnosis
Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / etiology
Cross-Sectional Studies
Humans
Multiple Sclerosis* / psychology
Neuropsychological Tests

Grants and funding

R61 AG069729/AG/NIA NIH HHS/United States