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Don’t be late! Timely identification of cognitive impairment in people with multiple sclerosis: a study protocol

  • Pauline T. Waskowiak,
  • Brigit A. de Jong,
  • Bernard M. J. Uitdehaag,
  • Shalina R. D. Saddal,
  • Jip Aarts,
  • Aïda A. M. Roovers,
  • Pim van Oirschot,
  • Vincent de Groot,
  • Frederieke G. Schaafsma,
  • Karin van der Hiele,
  • Marit F. L. Ruitenberg,
  • Menno M. Schoonheim,
  • Guy A. M. Widdershoven,
  • Sabina van der Veen,
  • Esther C. F. Schippers,
  • Martin Klein,
  • Hanneke E. Hulst,
  • Casper E. P. van Munster,
  • Renske G. Wieberdink,
  • Jolijn J. Kragt,
  • Judith Schouten,
  • Erwin L. J. Hoogervorst,
  • Paul A. D. Bouma,
  • Floris G. C. M. De Kleermaeker,
  • Meike Holleman,
  • Sofie Geurts,
  • Christaan de Brabander,
  • Nynke F. Kalkers,
  • Bram A. J. den Teuling,
  • Jos Vermeer,
  • Chris C. Schouten,
  • Gerard J. Stege,
  • Thijs van‘t Hullenaar

摘要

Background

Cognitive impairment occurs in up to 65% of people with multiple sclerosis (PwMS), negatively affecting daily functioning and health-related quality of life. In general, neuropsychological testing is not part of standard MS-care due to insufficient time and trained personnel. Consequently, a baseline assessment of cognitive functioning is often lacking, hampering early identification of cognitive decline and change within a person over time. To assess cognitive functioning in PwMS in a time-efficient manner, a BICAMS-based self-explanatory digital screening tool called the Multiple Screener©, has recently been developed. The aim of the current study is to validate the Multiple Screener© in a representative sample of PwMS in the Netherlands. Additionally, we aim to investigate how cognitive functioning is related to psychological factors, and both work and societal participation.

Methods

In this cross-sectional multicentre study, 750 PwMS (aged 18–67 years) are included. To obtain a representative sample, PwMS are recruited via 12 hospitals across the Netherlands. They undergo assessment with the Minimal Assessment of Cognitive Functioning in MS (MACFIMS; reference-standard) and the Multiple Screener©. Sensitivity, specificity, and predictive values for identifying (mild) cognitive impairment are determined in a subset of 300 participants. In a second step, the identified cut-off values are tested in an independent subset of at least 150 PwMS. Moreover, test–retest reliability for the Multiple Screener© is determined in 30 PwMS. Information on psychological and work-related factors is assessed with questionnaires.

Discussion

Validating the Multiple Screener© in PwMS and investigating cognition and its determinants will further facilitate early identification and adequate monitoring of cognitive decline in PwMS.