Cognition in multiple sclerosis depends on patients’ depression, anxiety, age
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Key takeaways:
- Older adults with multiple sclerosis had worse cognition compared with their younger counterparts.
- Cognitive function was determined by depressive symptoms, anxiety and age.
SAN FRANCISCO — Among patients with multiple sclerosis, cognitive function was predicted by age, depressive symptoms and anxiety, according to a poster presented at the American Psychiatric Association annual meeting.
David E. Freedman, MD, a resident physician at the University of Toronto in Canada, and colleagues retrospectively reviewed charts for 802 consecutive adult patients with MS who attended a tertiary neuropsychiatry clinic from 2006 to 2022. Patients were categorized as younger if they were aged younger than 50 years and older if they were aged 50 years or older.
Patients completed the Hospital Anxiety and Depression Scale (HADS) and the Minimal Assessment of Cognitive Function in MS (MACFIMS).
Within the cohort, older adults performed worse on cognitive tests assessing memory, processing speed and executive function compared with younger adults.
There were notable differences between age groups for the associations between depressive symptoms and cognition.
“Interestingly, what we found was that in younger people with MS, the core depressive symptoms were particularly predictive of cognitive impairment, while in older adults with MS, it’s more so the anxious distress in the context of depression that is predictive of cognitive impairment,” Freedman told Healio.
There were few independent associations between anxiety and cognition, according to the poster.
The findings suggest that clinicians should consider the role of depression and anxiety when working with patients with MS and consider neuropsychological testing, according to Freedman.
“What we have been able to establish here is the important role of depression in predicting cognitive impairment,” Freedman told Healio.
Moving forward, Freedman said research should investigate whether treatment depression improves cognitive outcomes for patients with MS.