ABSTRACT
As discussed in Chapter 3, impairment of one or more cognitive domains has been reported in 54-65% of MS patients in clinic-based studies and in 43-46% of patients in community-based samples.[1,2] The full spectrum of deficits that can occur includes impairment of attention, speed of information processing, learning, memory, executive function, and visual information processing. Basic language skills and verbal intelligence are relatively spared.[3] Cognitive impairment is a significant determinant of quality of life for patients with MS, who have higher rates of unemployment and greater social isolation and who require greater personal assistance at home than cognitively intact MS patients, even after controlling for the degree of physical disability.[4,5] Cognitive impairment can also affect safety, including child care and driving ability.[6] In this chapter, the practical management of cognitive impairment is discussed, including methods of identifying cognitive impairment in routine practice and potential treatment strategies.
