Promising New Approaches to Assess Cognitive Functioning in People with Multiple Sclerosis

Abstract

Cognitive impairment has a major impact on the lives of people with multiple sclerosis (MS). Yet it is often underdiagnosed, and more-effective assessment methods are needed. In particular, brief measures that focus on cognitive functioning in daily life situations, are sensitive to modest change over time, and do not require a highly skilled assessor merit exploration. The purpose of this exploratory study was to investigate the performance of individuals with MS on three relatively new measures—the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Concerns and Abilities Scales and the Everyday Problems Test (EPT)—and to compare scores on these measures with scores on neurocognitive performance measures typically used to assess cognitive functioning in people with MS. Twenty-nine individuals with MS who reported cognitive concerns participated in the study. Most were non-Hispanic white women with relapsing-remitting MS that was diagnosed approximately 18 years previously. All three measures yielded reliability coefficients of 0.80 or above and also demonstrated sensitivity to change following an educational intervention. Scores on the Revised EPT (EPT-R) were moderately correlated with scores on five standard neuropsychological measures. Compared with scores on the PROMIS Cognitive Concerns Scale, those on the self-reported PROMIS Cognitive Abilities Scale tended to correlate more highly with the neurocognitive performance measures, although the correlations were generally small. While results of this exploratory study are promising, future research should be conducted with larger and more diverse samples of people with MS to determine the broader utility of these measures.