Perceived Neuropsychological Impairment Inversely Related to Self-reported Health and Employment in Multiple Sclerosis.

BACKGROUND: MS patients frequently report cognitive difficulties which impact daily functioning.

OBJECTIVE: Investigate the relationship between patient-reported cognitive impairment and depression, demographic and MS-related variables, and clarify its impact on self-reported health measures and employment.

METHOD: A large 2-center survey included the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), 2-question screening tool for depression, vitality, Health-Related Quality of Life (HR-QoL), Health-Promoting Lifestyle Profile II (HPLP-II) and questions assessing social network satisfaction and employment status.

RESULTS: Of the 751 respondents (median age 54, median EDSS 5, 66.2% female), two thirds reported perceived neuropsychological impairment or depressive symptoms. While depressive symptoms were related to higher MSNQ scores, the MSNQ poorly predicted depression. After correcting for confounders, higher MSNQ scores and depressive symptoms decreased vitality, health-related quality of life and health promoting behaviors and increased the probability of being socially dissatisfied. In participants below retirement age, higher MSNQ and EDSS scores increased the probability of unemployment, while depression did not.

CONCLUSION: The contribution of the MSNQ to self-reported health measures and its unique explanatory power regarding unemployment suggest that subjective cognitive complaints are connected to subtle, yet meaningful, neuropsychological dysfunction. This article is protected by copyright. All rights reserved.