Disability, Cognition, and Quality of Life in Individuals With Multiple Sclerosis: A 2-Year Cohort Study

Abstract

Objectives

To evaluate longitudinal changes in cognition, depression, and health-related quality of life (HRQOL) over a 2-year follow-up in Japanese individuals with multiple sclerosis (MS), and also investigate whether cognition, depression, or HRQOL was associated with subsequent changes in Expanded Disability Status Scale (EDSS) scores.

Methods

The Brief International Cognitive Assessment for MS (BICAMS), Beck Depression Inventory-Second Edition (BDI-II), and Functional Assessment of MS (FAMS) were used to assess cognition, depression, and HRQOL, respectively, in 127 Japanese adults with MS (92 women, 35 men; mean age, 41.2 ± 10.7 years). A cross-lagged panel model analysis was used to examine longitudinal associations between each factor and EDSS scores.

Results

BICAMS scores at the 2-year follow-up were significantly higher than those at baseline. The increase in BICAMS scores from baseline to 2 years was greater in participants with baseline EDSS scores ≤ 3.0 than in those with scores ≥ 3.5. The cross-lagged panel model analysis showed that lower baseline scores on each of the three BICAMS tests were associated with higher EDSS scores 2 years later. Lower baseline FAMS scores, particularly for mobility and emotional well-being, also showed time-lagged associations with higher EDSS scores at the 2-year follow-up after accounting for autoregressive paths.

Conclusion

In Japanese individuals with MS, poorer baseline cognitive performance and some HRQOL measures were associated with worse EDSS outcomes at 2 years.