INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #92 Utility of the Brief Assessment of Cognitive Health (BACH) Computerized Screening Tool in Identifying MS-Related Cognitive Impairment Karlee Patrick, Kent State University, Kent, United States Shinjon Chakrabati, Case Western Reserve University, Cleveland, United States Tasha Rhoads, Cleveland Clinic Foundation, Cleveland, United States Robyn Busch, Cleveland Clinic Foundation, Cleveland, United States Darlene Floden, Cleveland Clinic Foundation, Cleveland, United States Rachel Galioto, Cleveland Clinic Foundation, Cleveland, United States Category: Multiple Sclerosis/ALS/Demyelinating Disorders Keyword 1: multiple sclerosis Keyword 2: cognitive screening Keyword 3: assessment Objective: Current guidelines recommend that individuals with MS are screened annually for processing speed deficits, often using the Symbol Digit Modalities Test (SDMT). However, given the heterogeneity of cognitive deficits in individuals with MS, other screening measures that assess a range of cognitive domains are necessary. The current study aimed to examine the ability of the computerized, self-administered Brief Assessment of Cognitive Health (BACH) screening measure to detect the presence of cognitive impairment in adults with MS as determined by performance on a standard neuropsychological test battery. Participants and Methods: Seventy-two individuals with MS completed the BACH and a comprehensive neuropsychological test battery. The BACH includes a brief history and demographics questionnaire, a well-validated depression screening measure, and measures of other factors that may impact cognition (e.g., education, psychiatric history). Then, the individual is presented with two memory subtests, a verbal memory subtest (words), and a nonverbal memory subtest (faces). BACH results include a metric that estimates probability of cognitive impairment (PCI) based on an individuals’ responses and performance, which was used in current study analyses. Cognitive impairment on testing was defined as performance <5th percentile on at least two cognitive tests in a single domain, or two tests in multiple domains. Chi square analyses were used to compare cognitively impaired and cognitively normal individuals on demographic characteristics and identify associations with clinical features. Receiver operating characteristic (ROC) analyses were conducted to investigate the ability of the BACH to identify cognitively impaired and cognitively intact individuals. ROC analyses were also conducted to compare the ability of the SDMT to discriminate between cognitively intact and cognitively impaired groups as a comparison with the BACH. Results: Cognitive impairment was observed in 56% of the sample. History of anxiety diagnosis was associated with meeting criteria for cognitive impairment (X² (1, N = 60) = 5.73, p = .03). The presence of other comorbidities (e.g., depression, headache, hypertension, sleep apnea) were not significantly associated with cognitive impairment. The BACH showed acceptable ability to discriminate between cognitively intact and cognitively impaired groups (AUC = 0.78, p < .001, 95% CI = 0.68 – 0.89; Sensitivity = 0.80; Specificity = 0.72). The SDMT did not demonstrate clinical utility in identifying individuals with cognitive impairment in this sample (AUC = 0.20). Conclusions: The BACH showed adequate ability to detect cognitive impairment in individuals with MS. The BACH was able to identify impairments across various assessed cognitive domains, including individuals with and without processing speed deficits. Given the heterogeneous patterns of cognitive impairment in MS, a screening tool capable of identifying impairment across a range of cognitive domains is important for improving detection of cognitive difficulties in this population. Identifying cognitive impairments early in the disease course is essential for improving care and quality of life of individuals with MS, and effective cognitive screening tools, such as the BACH, presents an important step in this process.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #92

Utility of the Brief Assessment of Cognitive Health (BACH) Computerized Screening Tool in Identifying MS-Related Cognitive Impairment

Karlee Patrick, Kent State University, Kent, United States
Shinjon Chakrabati, Case Western Reserve University, Cleveland, United States
Tasha Rhoads, Cleveland Clinic Foundation, Cleveland, United States
Robyn Busch, Cleveland Clinic Foundation, Cleveland, United States
Darlene Floden, Cleveland Clinic Foundation, Cleveland, United States
Rachel Galioto, Cleveland Clinic Foundation, Cleveland, United States

Category: Multiple Sclerosis/ALS/Demyelinating Disorders

Keyword 1: multiple sclerosis
Keyword 2: cognitive screening
Keyword 3: assessment

Objective:

Current guidelines recommend that individuals with MS are screened annually for processing speed deficits, often using the Symbol Digit Modalities Test (SDMT). However, given the heterogeneity of cognitive deficits in individuals with MS, other screening measures that assess a range of cognitive domains are necessary. The current study aimed to examine the ability of the computerized, self-administered Brief Assessment of Cognitive Health (BACH) screening measure to detect the presence of cognitive impairment in adults with MS as determined by performance on a standard neuropsychological test battery.

Participants and Methods:

Seventy-two individuals with MS completed the BACH and a comprehensive neuropsychological test battery. The BACH includes a brief history and demographics questionnaire, a well-validated depression screening measure, and measures of other factors that may impact cognition (e.g., education, psychiatric history). Then, the individual is presented with two memory subtests, a verbal memory subtest (words), and a nonverbal memory subtest (faces). BACH results include a metric that estimates probability of cognitive impairment (PCI) based on an individuals’ responses and performance, which was used in current study analyses. Cognitive impairment on testing was defined as performance <5th percentile on at least two cognitive tests in a single domain, or two tests in multiple domains. Chi square analyses were used to compare cognitively impaired and cognitively normal individuals on demographic characteristics and identify associations with clinical features. Receiver operating characteristic (ROC) analyses were conducted to investigate the ability of the BACH to identify cognitively impaired and cognitively intact individuals. ROC analyses were also conducted to compare the ability of the SDMT to discriminate between cognitively intact and cognitively impaired groups as a comparison with the BACH.

Results:

Cognitive impairment was observed in 56% of the sample. History of anxiety diagnosis was associated with meeting criteria for cognitive impairment (X² (1, N = 60) = 5.73, p = .03). The presence of other comorbidities (e.g., depression, headache, hypertension, sleep apnea) were not significantly associated with cognitive impairment. The BACH showed acceptable ability to discriminate between cognitively intact and cognitively impaired groups (AUC = 0.78, p < .001, 95% CI = 0.68 – 0.89; Sensitivity = 0.80; Specificity = 0.72). The SDMT did not demonstrate clinical utility in identifying individuals with cognitive impairment in this sample (AUC = 0.20).

Conclusions:

The BACH showed adequate ability to detect cognitive impairment in individuals with MS. The BACH was able to identify impairments across various assessed cognitive domains, including individuals with and without processing speed deficits. Given the heterogeneous patterns of cognitive impairment in MS, a screening tool capable of identifying impairment across a range of cognitive domains is important for improving detection of cognitive difficulties in this population. Identifying cognitive impairments early in the disease course is essential for improving care and quality of life of individuals with MS, and effective cognitive screening tools, such as the BACH, presents an important step in this process.