Multiple Sclerosis Cognitive Testing Clinic Declines
Nearly 15% of people with multiple sclerosis declined free cognitive testing offered at a specialized clinic in Canada, Multiple Sclerosis News Today reported.
Medical records from 334 adult patients revealed that individuals with progressive forms of the disease, anxiety disorders, or a lack of personal memory concerns frequently skipped the evaluation.
Specialized Clinic Patient Demographics
Patients attending the specialized neuropsychiatry clinic in Ontario had a mean age of 44.1 years, and 69.8% of the participants were women. Among the 332 patients with documented subtypes, 79.8% had relapsing-remitting multiple sclerosis, 11.7% had primary progressive disease, and 8.4% had secondary progressive disease.
While 81.4% of the group received referrals for cognitive screening, 14.7% actively declined the service. Another 3.9% were deemed ineligible, primarily due to language barriers regarding English fluency for the tests.
Progressive disease and anxiety increase screening refusal rates
Patients who turned down the screening were older on average and exhibited greater physical disability than those who accepted. They also showed higher rates of progressive disease subtypes and diagnosed anxiety-related conditions.
Researchers noted that these individuals frequently reported fewer subjective concerns about their thinking and memory. Adjusting for multiple variables, investigators found that progressive disease doubled the odds of refusal, while anxiety disorders increased those odds by 2.5 times.
Study findings highlight risks of undetected cognitive decline
The findings were published in the Multiple Sclerosis Journal under the title “Who declines neurocognitive testing? A cross-sectional study in people with multiple sclerosis. Study authors said these trends risk leaving cognitive decline undetected and creating gaps in clinical care.”
The research team acknowledged several limitations, including that participants came from a single specialized clinic and had already received referrals. Because the design was observational, it established associations rather than direct causation.
“Those with progressive MS or anxiety-related disorders and [people with MS] without cognitive concerns are more likely to decline neurocognitive testing,” the researchers wrote.
What specific cognitive skills does multiple sclerosis impact?
What specific cognitive skills does multiple sclerosis impact?
Multiple sclerosis affects memory, attention, and the ability to plan and organize daily activities, which can reduce overall quality of life. Clinical guidelines recommend routine screening to catch these issues early.
Why did patients without memory concerns decline testing?
Patients who reported no personal cognitive concerns often saw little utility in undergoing an evaluation. However, prior research cited by the study showed that about 40% of patients with few reported concerns still demonstrated impairment during actual testing.
What factors limited the scope of the patient study?
The investigation reviewed records from a single specialized neuropsychiatry center in Ontario involving patients who were already referred for evaluation. Researchers emphasized that further studies are needed to understand the broader factors influencing patient decisions.
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