Assessing everyday functional activity in cognitively impaired people with multiple sclerosis: The use of Actual RealityTM

Yael Goverover, Amber Salter, John DeLuca

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is considerable evidence that persons with multiple sclerosis (PwMS) who experience cognitive impairments (CIs) are at risk of having significant limitations in activities of daily living (ADLs). However, ADL assessment often consists of proxies or self-report of ADLs. This study examined whether the performance of instrumental ADLs (I-ADL) is impaired in PwMS with and without CI. Methods: Participants included 72 PwMS and 48 matched healthy controls (HCs). PwMS were divided into MS-CI (n = 25) and MS-not-impaired (n = 47) groups based on the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) scores. All participants performed the Actual RealityTM (AR) test, measuring I-ADL using authentic websites. Results: The MS-CI performed significantly worse on AR compared with HC and MS-not-impaired. In addition, the MS-not-impaired performed significantly worse than HC on AR. AR differentiates well between PwMS with and without CI. Conclusions: While CI in MS results in significant limitations in the performance of I-ADL, PwMS who do not show evidence of CI can have limitations in I-ADL. AR assessment is a valid and reliable tool sensitive to CI. It should be used in addition to traditional cognitive assessments to detect early functional deterioration through the course of MS.

Original languageEnglish (US)
Pages (from-to)1107-1117
Number of pages11
JournalMultiple Sclerosis Journal
Volume29
Issue number9
DOIs
StatePublished - Aug 2023

Keywords

  • activities of daily living
  • Cognitive disorder
  • cognitive rehabilitation
  • functional cognition
  • functional status
  • multiple sclerosis
  • outcome assessment

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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