COGNITIVE PERFORMANCE AND QUALITY OF LIFE IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

Introduction: Multiple sclerosis is a chronic, inflammatory, (auto) immune disease of the central nervous system. Cognitive impairment and the presence of depressive symptoms affect the quality of life. The aim was to determine the impact of cognitive disorders and depression on quality of life in patients with multiple sclerosis. Methods: The prospective study included 135 sick and 50 healthy subjects. Participants were divided into three groups: the first group consisted of 85 participants whose illness lasted longer than one year, the second group consisted of 50 participants with a newly diagnosed disease, the third group consisted of 50 healthy participants. Clinical assessment instruments were: Extended Disability Score in Multiple Sclerosis Patients, Mini Mental Status, Beck Depression Scale, Battery Tests for Cognitive Function Assessment: Wechsler Intelligence Scale, Revised Beta Test, Raven Colored Progressive Matrices, Wechsler Memory Test audio verbal learning, the Rey-Osterriecht complex character test, the Verbal Fluency Test, and the SF-36 quality of life assessment scale. Results: Cognitive disorders were present in 40-60% of participants with MS. Visuospatial, visuoconstructive and visuoperceptive functions are worse in the first group. Mnestic functions are most affected. Immediate working process memory, attention, short-term and logical memory is worse in the examinees of the first group. At the beginning of the disease, 16% had verbal fluency disorders, and as the disease progresses, the disorders become more pronounced. Conclusion: Cognitive disorders in MS patients are heterogeneous. They refer to impairments of working ability and memory, executive functions and attention, while global intellectual efficiency is later reduced. Quality of life is related to overall cognitive performance and shows a greater association with the degree of adaptation to the disease than with its symptoms.