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P0116 - Multiple Sclerosis and Cognitive Impairment: Computerized Cognitive Assessment and PROMIS-Cognitive Function Questionnaire: An Unfulfilled Promis (ID 1873)
Cognitive impairment (CI) is common in people with Multiple Sclerosis (PwMS) but often not addressed in routine care. Disease burden/progression in PwMS is traditionally measured by reported relapse, EDSS, and MRI change. CI is a source of significant disability independent of findings on examination. Use of a validated multi-domain screening cognitive assessment battery (NeuroTrax, CAB-NT) provides quantitative patient centric information to track CI longitudinally. Patient self-reported outcome measures (PRO) are also often used to gauge disability progression. PROMIS–Cognitive Function Short Form (CF-SF) is a validated disease agnostic PRO that can be incorporated to evaluate patient perception of disease impact. The relationship of the PROMIS PRO to a multi-domain quantitative cognitive assessment tool has not been explored in PwMS.
To examine the cross-sectional relationship between PRO PROMIS-Cognitive Function (CF-SF) scores and CAB-NT scores.
Retrospective review of consecutive PwMS who completed both the CAB-NT and PROMIS-CF-SF in the course of routine care on the same day. CAB-NT included 7 cognitive domains: memory (Mem), executive function (Exe), attention (Att), information processing speed (Inf), visual spatial (Vis), verbal function (Ver), motor skills (Mot) as well as a global cognitive summary score (GCS). Cognitive domains impaired (CDI, domain score’s <85) are also calculated.
147 PwMS, average age 49+/- 12, 70% female. Significant relationships (p<0.05) were identified through regression analysis with Pearson’s correlation coefficient (r) only for the following Cognitive Domain scores: GCS (r=0.27), Mem (r=0.23), Exe (r=0.27), Att (r=0.27), Inf (r=0.42), and Mot (r=0.27), CDI (r=0.4).
The PROMIS-Cognitive Function Short Form PRO does not provide a meaningful alternative to objective measures of CI in PwMS. Computerized Multi-domain Cognitive Testing provides an accurate tool to evaluate the degree of cognitive impairment across multiple relevant cognitive domains as well as the combination of domain impairment and accumulative cognitive impairment. The promise of the PROMIS-Cognitive Function Short Form to provide an effective PRO to evaluate cognitive impairment in PwMS has not been fulfilled.