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Cognitive impairment after three decades of multiple sclerosis
Author(s) -
Smestad C.,
Sandvik L.,
Landrø N. I.,
Celius E. G.
Publication year - 2010
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2009.02889.x
Subject(s) - medicine , expanded disability status scale , cognition , neuropsychology , multiple sclerosis , pediatrics , cohort , population , multivariate analysis , cognitive impairment , physical therapy , psychiatry , environmental health
Background: Population‐based studies of cognitive impairment in patients with multiple sclerosis (MS) with long disease duration are limited. The aim of this study was to evaluate long‐term outcome and the predictors of cognitive impairment in a cohort of patients with MS. Methods: Patients living in Oslo, Norway, with definite MS and onset in 1940–1980 alive on 1 May 2006 were included. Disability was assessed by Expanded Disability Status Scale (EDSS). Cognitive functioning was assessed in terms of psychomotor speed, attention, learning/memory and executive functions. Results: A total of 123 patients was included. EDSS was ≤3.0 in 26% and ≥6.0 in 60% after mean disease duration of 34.5 years. Cognitive impairment was found in 48% of the patients eligible for neuropsychological evaluation ( n = 84). Typical pattern was moderate impairment within areas of information processing, attention and memory. In the univariate analysis, younger onset age was significantly associated with cognitive impairment ( P = 0.014). Younger onset age ( P = 0.017) and disease course (secondary progressive vs. relapsing‐remitting MS, P = 0.049) were significantly associated with cognitive impairment in the multivariate analysis. Conclusions: After three decades of disease, half of the MS patients experienced reduced cognitive functioning; however, nearly one‐third of the patients were only mildly disabled based on the EDSS. Younger onset age was associated with higher prevalence of cognitive impairment. A thorough evaluation of cognitive function in addition to EDSS is essential for evaluating long‐term impairment in patients with MS.