Decreased Activity Levels in MS Patients Linked To Cognitive Impairment

A new study published in the American Journal of Occupational Therapy assessed the cognitive factors affected in multiple sclerosis patients concerning their activity and participation in everyday life. The study is entitled “Factors That Moderate Activity Limitation and Participation Restriction in People With Multiple Sclerosis” and was conducted by researchers at the Kessler Foundation, a nonprofit organization focused on the field of disability and rehabilitation research.

MS is a chronic, progressive neurodegenerative disorder that results from the attack on the central nervous system (brain, spinal cord and optical nerves) by the body’s own immune system, resulting in motor function impairment (coordination, balance, speech and vision), irreversible neurological disability and paralysis. Most MS patients experience their first symptoms between 20 and 40 years of age and it is estimated that more than 2.3 million people in the world suffer from the disease. There is currently no cure for MS.

MS is considered the leading cause of disability among working age adults, and it can have a significant negative impact on a patient’s quality of life. It is estimated that within five years after disease diagnosis, the rate of employment drops from 90% to 20-30%. In addition, only around 35% of MS patients report normal social and lifestyle activities.

The identification of factors linked to the limitations experienced by MS patients may help occupational therapists develop effective intervention strategies. Since cognitive impairment is frequently linked to a decline in social participation and employment, in the study, researchers investigated cognitive factors linked to both activity and participation.

In total, 72 MS patients were evaluated in terms of their cooking ability as a measure of their activity limitation, and employment status as a measure of their participation restriction. All patients were assessed through neuropsychological testing of memory, visual perception, executive function and processing speed. In addition, participants completed questionnaires concerning affective symptoms, fatigue, activity and participation.

Researchers found that processing speed was the only factor significantly related to both activity and participation. When analyzing specific isolated aspects, employment status was found to be significantly associated with processing speed, visual memory education level and fatigue, while cooking ability was linked to the processing speed, verbal memory and working memory.

The research team concluded that processing speed seems to be a primary cognitive factor in MS patients that can have an impact on the quality of both activity and participation in the patient’s everyday life.

“The only variable significantly related to activity and participation was processing speed,” concluded the study’s lead author Dr. Yael Goverover 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.”