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Assessing Cognitive Dysfunction in Patients With Multiple Sclerosis

Posted Nov 24 2010 12:00am
Information provided by (our Ask the MS Nurse): Cherie C. Binns RN BS MSCN

SAN ANTONIO—The Mini-Mental Status Examination (MMSE) is not sufficiently sensitive to identify cognitive dysfunction in a small sample of patients with multiple sclerosis (MS), researchers reported at the 24th Annual Meeting of the Consortium of Multiple Sclerosis Centers. Thus, patients with MS should undergo an objective cognitive screening test, according to Corey Burchette, PsyD, of the Multiple Sclerosis Center, Neurology Center of Fairfax in Virginia, and colleagues.

Detecting Cognitive Impairment in MSThe study evaluated the effectiveness of two proposed cognitive screening test batteries in comparison to a full neuropsychologic evaluation in a group of 10 patients with MS (mean age of 41 and mean of 17 years of education). Both batteries included the MMSE, a verbal fluency test, Boston Naming test, and Trail Making Test (parts A and B). One also included the Beck Depression Inventory and Hopkins Verbal Learning Test, while the second battery included the Geriatric Depression Scale and Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word List Memory test.

All 10 participants in the pilot study scored above the cutoff for memory measures on the MMSE, while 30% scored above the cutoff on the cognitive screening test. The brief cognitive screening test provides reasonable sensitivity and specificity and includes a number of core components of mental functioning, noted the investigators.
The cognitive screening test was able to detect the measurable memory impairments demonstrated by the full neuropsychologic evaluation, according to the researchers. Furthermore, the test detected a higher degree of cognitive impairment than was found on the full neuropsychologic evaluation, they said.
How Effective Is the MMSE?

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