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Rachel M Butler Pagnotti, Le Hanh Hua, Justin B Miller, A-70 Differences in Cognition and Disease Characteristics in Adult Vs. Late Onset Multiple Sclerosis, Archives of Clinical Neuropsychology, Volume 36, Issue 6, September 2021, Page 1112, https://doi.org/10.1093/arclin/acab062.88
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Abstract
Cognitive impairment is a common sequelae of multiple sclerosis(MS), however, relatively little is known about cognitive impairment in late-onset MS (LOMS; symptom onset >50 years old). The present study investigated differences in disease characteristics and cognition in LOMS and adult-onset MS (AOMS).
Archival medical records and neuropsychological evaluations from an MS specialty center were reviewed. Differences in disease characteristics between 57 LOMS and 124 AOMS patients were compared using chi-square or ANOVA. To investigate differences in cognitive functioning, age-adjusted standardized scores were compared via ANCOVA, using cardiac risk factors and disease duration as covariates.
Compared to AOMS (age range: 21–88; mean age: 49.66 +/−12.83), LOMS patients (age range 42–82; mean age: 61.88 +/− 8.57) had significantly more cardiac comorbidities (mean: 1.12+/−1.1 vs. 0.6+/−0.9; p < 0.01), shorter disease duration (mean years: 13.14+/−7.9 vs. 21.0+/−12.6; p < 0.001), and shorter time to diagnosis (mean years: 3.0+/−4.2 vs 6.5+/−8.5; p < 0.01). LOMS patients had similar Expanded Disability Status Scale scores and number of prescribed disease-modifying therapy as AOMS. LOMS patients demonstrated greater impairment on Brief Visuospatial Memory Test-Revised learning (F(1,169) = 8.03, p < 0.05; d = 0.36) and delayed recall (F(1,169) = 4.44, p < 0.05; d = 0.27), and on Wechsler Adult Intelligence Scale-4th edition Digit Span Backward (F(1,176) = 5.68, p < 0.05; d = 0.41) and Sequencing (F(1, 176) = 11.90, p < 0.001; d = 0.55) subtests.
Despite a shorter disease duration and quicker diagnosis, LOMS patients demonstrate similar levels of physical impairment. Moreover, even after accounting for differences in disease duration and cardiac risk, LOMS showed a greater burden of cognitive impairment than AOMS, which taken together, suggests an elevated rate of disease progression in LOMS.
