Addressing patient-reported cognitive impairment in multiple sclerosis clinical practice: A challenging endeavor

Cognitive impairment (CI) is a common and disabling symptom in people with multiple sclerosis (PwMS), significantly affecting employment outcomes and quality of life. Despite its prevalence, routine assessment of CI is often hindered by limited access to comprehensive neuropsychological evaluations and challenges in interpreting subjective concerns. The relationship between objective and subjective measures of cognition is complex and often discordant. This review provides an overview focused on patient-reported CI, emphasizing on the association with objective measures of CI, the role of confounding factors, and the limitations of current screening approaches. Regardless of the underlying processes driving these concerns, patient-reported CI has a significant impact on day-to-day quality of life of PwMS and needs to be efficiently evaluated and addressed as several reversible causes can be managed efficiently when detected.