Related Experiment Video
Updated: Sep 3, 2026
The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
The association between BMI and cognition, disability, and quality of life markers in multiple sclerosis: DISCOMS
Aliza Bitton Ben-Zacharia1,2, Gary Cutter3, Alya Shor4
1Graduate Program, Hunter College Bellevue School of Nursing, 60 West Street, New York, NY 10006, USA.
Background:
The association between body mass index (BMI) and cognition, disability, and quality of life (QoL) is controversial in multiple sclerosis (MS).
Objectives:
We investigated the association between BMI and cognitive function, disability, and QoL in MS.
Methods:
A cross-sectional secondary analysis of the DISCOMS trial was performed to study the association between BMI and cognition, disability, and QoL. Cognitive function was measured by the symbol digit modalities test (SDMT) and disability was measured based on the expanded disability status scale (EDSS) and patient determined disability steps (PDDS). QoL markers were measured by the Quality of Life in Neurological Disorders. Descriptive and inferential statistics were used to analyze the association between BMI and cognition, disability, and QoL.
Results:
The study included 253 participants, mostly female (83.8%) and white (89.3%). Their mean BMI was 27.27 (SD = 5.6), and 62% were overweight, obese, or very obese. Controlling for age, gender, and disease-modifying therapy duration, BMI as a continuous or as a categorical variable was not associated with cognitive function as measured by the SDMT or disability as measured by the EDSS and/or the PDDS. EDSS as a dichotomous variable was associated with BMI; 1-unit increase in BMI was associated with a 5.7% increase in the odds of having an EDSS score greater than 4 (β = 0.055, p = 0.045). Higher continuous BMI was associated with physical domains dysfunction; worse fatigue (p = 0.009), and worse lower extremities function (p = 0.008), while the very obese group had a higher risk of physical and emotional domain dysfunction than the normal BMI group.
Conclusion:
The lack of observed associations between BMI and cognitive function or disability in this older MS cohort suggests that the relationship between BMI and clinical outcomes may vary across domains. Nevertheless, the associations identified between BMI and QoL measures emphasize the potential importance of weight management in supporting overall health and well-being among individuals with MS.
Trial Registration Of The Primary Discoms Study:
ClinicalTrials.gov NCT03073603.
