Screening for Cognitive Impairments in People with Multiple Sclerosis

Multiple Sclerosis is the most commonly found neurological condition among young adults and in early adulthood. Symptoms exhibit ‘disease heterogeneity’ and vary from sufferer to sufferer. Cognitive impairments in the domains of processing speed, memory, attention, visuospatial perception and executive function are commonly found. Literature Review: A systematic review of the literature on screening for cognitive impairments is presented. The paper considers the key measures of validity and reliability for the screening tests reviewed and uses a standard appraisal tool to assess the methodology of each study. The review concludes that, of the wide variety of tools, which will be best to use is dependent upon the needs of the client and the resources of the service assessing them. Research Report: The study examined the combined validity of two short screening tests – the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) and Symbol Digit Modalities Test (SDMT). Logistic regression was used to generate a combined score for the two tests which was compared to the Minimal Assessment of Cognitive Function In Multiple Sclerosis (MACFIMS) psychometric battery as a ‘gold standard’ measure and Receiver Operating Characteristic (ROC) analysis carried out. While the sample was underpowered, the logistic regression method produced superior area under the curve for the combined scores. Clinical implications of the results, recommendations based on the findings and potential future research projects were discussed. Critical Appraisal: A reflective account of the process of carrying out the research and what was learned from it is provided.