Patient Attitudes to Routine Cognitive Testing in Multiple Sclerosis

Area of Science:

• Neurology
• Neuropsychology
• Quality of Life Research

Background:

• Cognitive dysfunction (CD) is increasingly recognized in multiple sclerosis (MS).
• Neuropsychological tests exist to monitor cognitive changes in MS patients.
• Patient attitudes towards routine cognitive testing in MS are largely unexplored.

Purpose of the Study:

• To explore the attitudes of multiple sclerosis patients towards the introduction of routine cognitive testing.
• To understand the relationship between quality of life (QoL) impact of CD and patient attitudes.

Main Methods:

• Qualitative study involving semi-structured interviews with 12 Danish MS patients.
• Participants represented diverse perspectives on CD, including relapsing-remitting MS (RRMS) and secondary-progressive MS (SPMS) subtypes.
• Data analysis employed a constructivist approach to examine QoL impact and attitudes towards cognitive testing using the Symbol Digit Modalities Test (SDMT).

Main Results:

• Subjective and objective cognitive dysfunction (CD) did not always align, nor directly correlate with poorer quality of life (QoL).
• CD impacted QoL more significantly in RRMS patients with higher SDMT scores compared to SPMS patients.
• All patients supported routine cognitive testing, citing reasons such as research support, treatment optimization, and documenting an invisible symptom.

Conclusions:

• Cognitive dysfunction (CD) can affect all aspects of multiple sclerosis (MS) patients' quality of life (QoL).
• Patients across all MS phases widely support routine cognitive testing.
• Comprehensive care for MS should integrate management of both physical and cognitive impairments.