Highlights
- •The cognitive profiles of multiple sclerosis and Alzheimer's disease are distinct.
- •Multiple sclerosis is not associated with impairment of memory consolidation.
- •Multiple sclerosis and mild cognitive impairment share a deficit in verbal fluency.
- •Poor memory retention in multiple sclerosis merits further dementia work-up.
Abstract
Background
Cognitive impairment can be seen in patients of all ages with multiple sclerosis (MS).
However, there is limited research on neurocognitive disorder in older adults with
MS and how to detect Alzheimer's disease (AD) or its prodromal stage, amnestic mild
cognitive impairment (aMCI). Thus, the MS clinician is challenged to discriminate
between signs of MS-related cognitive decline versus a secondary neurodegenerative
process.
Objective
Compare cognition in older MS patients to patients with AD and aMCI.
Methods
We evaluated cognitively impaired and unimpaired MS patients, AD patients, aMCI patients,
and healthy controls (HCs), all elderly (n = 20 per group). AD and aMCI diagnoses
were derived by consensus conference independent of the MS research project. Neuropsychological
measures assessed domains commonly affected in AD, including verbal memory and expressive
language.
Results
Cognitively impaired and unimpaired MS groups did not differ on any measures sensitive
to AD. Unimpaired MS patients were comparable to HCs. Impaired MS patients showed
decreased semantic fluency, similar to aMCI patients. Lastly, while both AD and aMCI
groups had deficient memory retention, there was no evidence of a retention deficit
in either MS group.
Conclusion
Our findings suggest that the cognitive profiles of MS and AD are distinct. In contrast
to AD, MS is not associated with impairment of memory consolidation. However, there
may be overlap between cognitive deficits related to MS and aMCI. Thus, evidence of
poor memory retention, in an older MS patient may merit comprehensive dementia evaluation.
The study is preliminary and includes no AD biomarkers (e.g., amyloid imaging) to
confirm or rule out AD pathology.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Multiple Sclerosis and Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cognitive reserve and cortical atrophy in multiple sclerosis: a longitudinal study.Neurology. 2013; 80: 1728-1733
- Minimal neuropsychological assessment of MS patients: a consensus approach.Clin. Neuropsychol. 2002; 16: 381-397
- Brief International Cognitive Assessment for MS (BICAMS): international standards for validation.BMC Neurol. 2012; 12: 55
- Brief Visuospatial Memory Test - Revised: Professional Manual.Psychological Assessment Resources, Inc, Odessa, Floriday1997
- Minimal neuropsychological assessment of MS patients: a consensus approach.Clin. Neuropsychol. 2002; 16: 381-397
- Minimal neuropsychological assessment of MS patients: a Consensus approach.Clin. Neuropsychol. 2002; 16: 381-397
- Deficiency of autophagy in dendritic cells protects against experimental autoimmune encephalomyelitis.J. Biol. Chem. 2014; 289: 26525-26532
- Cognitive aging in patients with multiple sclerosis: a cross-sectional analysis of speeded processing.Arch. Clin. Neuropsychol.: Off. J. Natl. Acad. Neuropsychol. 2009; 24: 761-767
- Longitudinal verbal fluency in normal aging, preclinical, and prevalent Alzheimer's disease.Am. J. Alzheimer'S. Dis. Other Dement. 2009; 24: 461-468
- Califorina Verbal Learning Test. Second ed. The Psychological Corporation, San Antonio, TX2000
- Delis-Kaplan Executive Function System.The Psychological Corporation, San Antonio, TX2001
- A comparison of dementia in Alzheimer's disease and multiple sclerosis.Arch. Neurol. 1989; 46: 157-161
- Boston Naming Test.Lea & Febiger, Philadelphia1983
- Verbal fluency deficits in multiple sclerosis.Neuropsychologia. 2006; 44: 1166-1174
- Usefulness of logical memory II of WMS-R in memory clinic outpatients.Alzheimer'S. Dement.: J. Alzheimer'S. Assoc. 2010; 6: S482-S483
- Demonstration of a lexical access deficit in relapsing-remitting and secondary progressive forms of multiple sclerosis.Rev. Neurol. 2014; 170: 527-530
- Cognitive impairment in newly diagnosed multiple sclerosis patients: a 4-year follow-up study.J. Neurol. Sci. 2006; 245: 77-85
- Donepezil improves memory in multiple sclerosis in a randomized clinical trial.Neurology. 2004; 63: 1579-1585
- Multicenter randomized clinical trial of donepezil for memory impairment in multiple sclerosis.Neurology. 2011; 76: 1500-1507
- A useful annual review of cognition in relapsing MS is beyond most neurologists–NO.Mult. Scler. J. 2016; (1352458516640610)
- General health issues in multiple sclerosis: comorbidities, secondary conditions, and health behaviors.Continuum (Minneapolis, Minn). 2013; 19: 1046-1057
- Effect of comorbidity on mortality in multiple sclerosis.Neurology. 2015; 85: 240-247
- A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: overview.Mult. Scler. (Houndmills, Basingstoke, Engl.). 2015; 21: 263-281
- Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease.Neurology. 1984; 34: 939-944
- Cognitive reserve moderates the impact of subcortical gray matter atrophy on neuropsychological status in multiple sclerosis.Mult. Scler. J. 2015; 22: 36-42
- The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease.Neurology. 1989; 39: 1159-1165
- Recognition performance differentiates between elderly patients in the long term course of secondary progressive multiple sclerosis and amnestic mild cognitive impairment.Mult. Scler. J. 2013; 19: 799-805
- A comparison of the brief international cognitive assessment for multiple sclerosis and the brief repeatable battery in multiple sclerosis patients.BMC Neurol. 2015; 15: 204
- Mild cognitive impairment as a diagnostic entity.J. Intern. Med. 2004; 256: 183-194
- Clinical practice. Mild cognitive impairment.New Engl. J. Med. 2011; 364: 2227-2234
- Autophagy and microglia: novel partners in neurodegeneration and aging.Int. J. Mol. Sci. 2017; : 18
- Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.Ann. Neurol. 2011; 69: 292-302
- A Manual for the Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis.National Multiple Sclerosis Society, 1991
- Differential effects of aging on motor and cognitive functioning in multiple sclerosis.Mult. Scler. J. 2016;
- Association between physical fitness and cognitive function in multiple sclerosis.Neurorehabilitation Neural Repair. 2014; 29: 214-223
- Genetic studies of quantitative MCI and AD phenotypes in ADNI: Progress, opportunities, and plans.Alzheimer'S. Dement. 2015; 11: 792-814
- Symbol Digit Modalities Test: Manual.Western Psychological Services, Los Angeles1982
- A compendium of neuropsychological tests: administration, norms, and commentary.American Chemical Society, 2006
- PET Amyloid-Beta Imaging in Preclinical Alzheimer's Disease.Biochim. Et. Biophys. Acta. 2012; 1822: 370-379
- Instruction Manual for the Wechsler Memory Scale Revised.Psychological Corporation, New York1987
Article info
Publication history
Published online: March 13, 2018
Accepted:
March 9,
2018
Received in revised form:
February 7,
2018
Received:
July 2,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
