Cognitive Impairments Impact Multiple Sclerosis Patients' Activity and Participation

Participation in daily life activities is primarily hindered by reduced processing speed in patients with multiple sclerosis (MS), according to the results of a study published in the American Journal of Occupational Therapy.

Researchers from the Kessler Foundation in West Orange, New Jersey examined the lifestyles of 72 MS patients in order to evaluate the variables most often associated with activity limitations (such as cooking) and participation restriction (like employment). The team wanted to find out why cognitive impairments are often the culprit of declines in social participation and employment. The authors added that this is the first study of its kind to examine cognition combined with measures of activity levels and participation.

The patients underwent comprehensive neuropsychological testing which assessed memory, executive functions, visual perception, and processing speed. The study subjects also completed surveys which examined their activity, participation, fatigue, and affective symptoms.

The investigators found that processing speed was the only variable linked to both activity and participation across the board. In examining specific aspects of activity and participation in isolation, the researchers continued, employment status was significantly linked to education level, visual memory, fatigue, and processing speed.

Meanwhile, cooking ability was linked to performance on tasks of working memory, verbal memory, and processing speed. These findings highlight the researchers’ hypothesis, which states that processing speed is a primary cognitive factor in MS. Additionally, MS is impacted by cognitive factors on several fronts — quality of activity and participation in a typical daily lifestyle.

“The only variable significantly related to activity and participation was processing speed,” explained study author Yael Goverover, PhD, in a press release. “For occupational therapists, this means that implementing strategies that improve processing speed may help people with MS maintain their daily activities and stay in the workplace. In light of the close association between cognitive factors and cooking, providers should be aware that decline in cooking skills may be sign of cognitive decline in MS.”

Statistics show that employment rates decline from 90 percent to between 20 and 30 percent within 5 years of an MS diagnosis, the statement continued. Plus, only about a third of MS patients report normal social and lifestyle activities.

In the future, the authors hope that they can continue to work to identify variables associated with the limitations they pinpointed. In turn, the team believes that deeper findings will aid occupational therapists in their hunt to develop successful interventions.