The Executive Dysfunctions Most Commonly Associated with Multiple Sclerosis and Their Impact on Occupational Performance

Abstract

Introduction: The relationship between executive dysfunction and functional status in people with multiple sclerosis (MS) is not fully understood. This study attempts to provide empirical evidence of the executive dysfunctions most commonly associated with MS and to develop an understanding of the impact of this on occupational performance. Method: This cross-sectional study explores the relationships between an MS group (n = 69) and a healthy control group (n = 30) using the Behavioural Assessment of Dysexecutive Syndrome and the Dysexecutive Questionnaire. Results: More than a third of people with MS experienced some impairment of executive function sufficient to interfere with occupational performance. The most commonly occurring problems included planning, problem solving, behavioural regulation, lack of insight, apathy and lack of motivation. Executive function deficits were evident from the early stages of the disease, although participants with a secondary progressive form of MS appeared to demonstrate greater difficulties. Conclusion: While the Behavioural Assessment of Dysexecutive Syndrome may reliably identify the presence of executive dysfunction within this clinical population it does not inform clinicians of the impact on occupational performance. Self-reported executive function demonstrates heightened awareness of occupational performance deficits and may lead to more accurate reporting of executive dysfunction. The impact of depression, fatigue and anxiety, however, requires further investigation.