Cognitive dysfunction and mortality in multiple sclerosis: Long-term retrospective review

Author:

Cavaco Sara1ORCID,Ferreira Inês1,Moreira Inês1,Santos Ernestina2,Samões Raquel2,Sousa Ana Paula3ORCID,Pinheiro Joaquim4,Teixeira-Pinto Armando5,Martins da Silva Ana2ORCID

Affiliation:

1. Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal/Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal

2. Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal

3. Neurophysiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal

4. Neurology Department, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal

5. Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia

Abstract

Background: Cognitive dysfunction as a predictor of clinical progression and mortality in multiple sclerosis (MS) is still a matter of debate. Objective: The aim of this study was to explore the long-term outcome associated with neuropsychological performance in a cohort of patients with MS. Methods: A series of 408 MS patients had previously undergone a comprehensive neuropsychological assessment and a contemporaneous neurological evaluation (T1). A retrospective review of the clinical records was conducted 102–192 months after T1. Demographic and clinical data regarding the last clinical appointment with EDSS measurement (T2) were collected and the date of the last clinical contact or death (TS) was recorded. Results: This review revealed that cognitive dysfunction (T1) was associated with higher odds of transitioning from relapsing–remitting course to a progressive disease course (adjusted odds ratio (OR) = 2.29, p = 0.043) and higher hazard of death in the total sample (adjusted hazard ratio (HR) = 3.07, p = 0.006) and the progressive disease course subgroup (adjusted HR = 3.68, p = 0.007), even when adjusting for other covariates. Discussion: The study results demonstrate that cognitive dysfunction in MS is predictive of poorer prognosis and mortality.

Publisher

SAGE Publications

Subject

Neurology (clinical),Neurology

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