Cognition and Health-related Quality of Life in Multiple Sclerosis

Abstract

Background: Cognitive dysfunctions are considered as a poor prognostic factor that influence health-related quality of life in multiple sclerosis. Objective: The aim of the study was to evaluate the impact of cognitive impairment on the quality of life in multiple sclerosis patients. Methods: This study included 60 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were clinically definite diagnosis of multiple sclerosis, 18 years of age or older and were able to give written informed consent. Cognitivefunction was evaluated by the Montreal Cognitive Assessment (MoCa) screening test. Quality of life was evaluated by SF36 questionnaire. Results: 88.33% of patients had cognitive impairment with 68.33% with mild cognitive impairment. Abstraction (60,83%), language (56,66%), executive functions (53.66%) and delayed recall (28.33%) were rated the worst. The median value of SF-36 score was 54.1 (27.7-70.01). The lowest results were achieved in the QOL domains of psycial limitation with a median value of 12.5 (0-75) and emotional limitation 33.3 (0-100). It is found statistically significant correlation of the MoCa score with social functioning, energy, vitality and general health (p<0.05) and physical functioning (p<0.001) domains of quality of life, as well as with SF -36 total scores (p<0.05). Among group of patients with cognitive impairment, statistically significant positive correlation between cognitive status mental health HRQOL domain (rho=0.427; p<0.001) was found. Conclusion: Cognitive impairment is very often presented in patients with multiple sclerosis with significant contribution to a poorer quality of life. It is associated with physical and emotional limitations, as well as poorer mental health. Further studies are needed, especially when we take into account very important clinical and prognostic role of cognition in multiple sclerosis.