Abbey J Hughes1, Narineh Hartoonian2, Brett Parmenter3, Jodie K Haselkorn4, Jesus F Lovera5, Dennis Bourdette6, Aaron P Turner7. 1. Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA. Electronic address: ajhughes@uw.edu. 2. Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA. 3. Veterans Affairs Puget Sound Health Care System, American Lake Division, Tacoma, WA. 4. Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA. 5. Department of Neurology, Louisiana State University Health Science Center, New Orleans, LA. 6. Multiple Sclerosis Center of Excellence West, Veterans Affairs Portland Health Care System, Portland, OR; Department of Neurology, School of Medicine, Oregon Health and Science University, Portland, OR. 7. Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
Abstract
OBJECTIVES: To determine the association between unique domains of cognitive impairment and community integration in individuals with multiple sclerosis (MS), and to determine the contributions of cognitive impairment to community integration beyond the influence of demographic and clinical variables. DESIGN: Cross-sectional analysis of objective neuropsychological assessment and self-report data. Data were collected during baseline assessment of a randomized, multisite controlled trial of ginkgo biloba for cognitive impairment in MS. Hierarchical regression analyses examined the association between subjective and objective measures of cognitive impairment and 3 domains of community integration, adjusting for relevant covariates. SETTING:Two Veterans Affairs medical center MS clinics. PARTICIPANTS: Adults (N=121; ages 24-65y) with a confirmed MS diagnosis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Primary outcomes were scores on the Home Integration (CIQ-H), Social Integration (CIQ-S), and Productivity (CIQ-P) domains of the Community Integration Questionnaire (CIQ). RESULTS:Cognitive impairment was associated with lower scores on the CIQ-H and CIQ-S, but not the CIQ-P. Greater levels of subjective cognitive impairment were associated with lower scores on the CIQ-H and CIQ-S. Greater levels of objective cognitive impairment, specifically slower processing speed and poorer inhibitory control, were related to lower CIQ-S scores. Subjective and objective measures of cognitive impairment were significantly and independently associated with CIQ-S. CONCLUSIONS:Objective cognitive impairment may interfere with participation in social activities. Subjective cognitive impairment is also important to assess, because individuals who perceive themselves to be cognitively impaired may be less likely to participate in both home and social activities. Clinical interventions to enhance community integration in individuals with MS may benefit from addressing objective and subjective cognitive impairment by integrating cognitive rehabilitation approaches with self-efficacy-enhancing strategies.
RCT Entities:
OBJECTIVES: To determine the association between unique domains of cognitive impairment and community integration in individuals with multiple sclerosis (MS), and to determine the contributions of cognitive impairment to community integration beyond the influence of demographic and clinical variables. DESIGN: Cross-sectional analysis of objective neuropsychological assessment and self-report data. Data were collected during baseline assessment of a randomized, multisite controlled trial of ginkgo biloba for cognitive impairment in MS. Hierarchical regression analyses examined the association between subjective and objective measures of cognitive impairment and 3 domains of community integration, adjusting for relevant covariates. SETTING: Two Veterans Affairs medical center MS clinics. PARTICIPANTS: Adults (N=121; ages 24-65y) with a confirmed MS diagnosis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Primary outcomes were scores on the Home Integration (CIQ-H), Social Integration (CIQ-S), and Productivity (CIQ-P) domains of the Community Integration Questionnaire (CIQ). RESULTS:Cognitive impairment was associated with lower scores on the CIQ-H and CIQ-S, but not the CIQ-P. Greater levels of subjective cognitive impairment were associated with lower scores on the CIQ-H and CIQ-S. Greater levels of objective cognitive impairment, specifically slower processing speed and poorer inhibitory control, were related to lower CIQ-S scores. Subjective and objective measures of cognitive impairment were significantly and independently associated with CIQ-S. CONCLUSIONS: Objective cognitive impairment may interfere with participation in social activities. Subjective cognitive impairment is also important to assess, because individuals who perceive themselves to be cognitively impaired may be less likely to participate in both home and social activities. Clinical interventions to enhance community integration in individuals with MS may benefit from addressing objective and subjective cognitive impairment by integrating cognitive rehabilitation approaches with self-efficacy-enhancing strategies.
Authors: Brian M Sandroff; M David Diggs; Marcas M Bamman; Gary R Cutter; Jessica F Baird; C Danielle Jones; John R Rinker; Glenn R Wylie; John DeLuca; Robert W Motl Journal: Contemp Clin Trials Date: 2019-11-05 Impact factor: 2.226
Authors: Anna L Kratz; Tiffany J Braley; Emily Foxen-Craft; Eric Scott; John F Murphy; Susan L Murphy Journal: Arch Phys Med Rehabil Date: 2017-07-18 Impact factor: 3.966
Authors: Anna L Kratz; Dawn M Ehde; Marisol A Hanley; Mark P Jensen; Travis L Osborne; George H Kraft Journal: Arch Phys Med Rehabil Date: 2015-10-31 Impact factor: 3.966