• Login
    View Item 
    •   UTSW DSpace Home
    • UT Southwestern Electronic Theses and Dissertations
    • UT Southwestern Electronic Theses and Dissertations
    • View Item
    •   UTSW DSpace Home
    • UT Southwestern Electronic Theses and Dissertations
    • UT Southwestern Electronic Theses and Dissertations
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Use of Cognitive Screening and the Influence of Psychosocial Variables in Identification of Cognitive Impairment in MS

    Thumbnail
    View/Open
    Dissertation available after 5-13-2013 (516.8Kb)
    Date
    2013-05-17
    Author
    Ritter, Ashley Reyes
    Metadata
    Show full item record
    Abstract
    BACKGROUND: The purpose of this project is to examine the potential of abbreviated cognitive screening to identify patients with clinically significant cognitive dysfunction. A secondary goal is to examine relationships between cognitive functioning and psychosocial factors of disease. SUBJECTS: The study includes 94 subjects with a Demyelinating disease [M age = 45.04 (11.08); M education = 15.40 (2.13)] who were referred to the University of Texas Southwestern Medical Multiple Sclerosis Clinical Center and Multiple Sclerosis Program and signed informed consent for a larger study on cognition in multiple sclerosis and demyelinating disease. METHOD: Subjects completed a screening battery (JoL, 9HPT, PASAT, SDMT-Oral, and T25FW) at visit one and a larger cognitive assessment within 4 weeks of visit one, which was used to divide subjects into impaired and non-impaired groups. Linear regression was used to assess which tests on the screening battery predicted impairment on the longer battery. Associations between psychosocial factors of depression, fatigue, and sleepiness were examined in relation to cognitive performance. The relationship between depression and objective versus subjective cognitive performance was also examined. RESULTS: The PASAT (p = .001) was the only measure in the screening battery that predicted group membership, with correct classification of 76% of subjects using a cut score of T ² 38. Depression (QIDS-SR) was significantly correlated with self-reported cognitive dysfunction (MSNQ) (r = .57; p = <.001) but only modestly associated with the four measures on the screening battery (r = -.17 to .25). Those who endorsed depressive symptoms performed lower on JoL(p = .003), PASAT (p = .015) and SDMT (p = .023). Level of fatigue was associated with cognitive performance, as significant mean differences were found on all screening battery measures in high versus low fatigue groups. There was no impact of sleepiness on cognition. DISCUSSION: Complex attention was the most sensitive measure for predicting cognitive impairment on a more comprehensive battery and may be a good screening tool in identifying who might benefit from more detailed testing. Higher levels of depression and fatigue significantly impacted test performance and highlight important areas for screening and treatment, while daytime sleepiness had no effect.
    URI
    http://hdl.handle.net/2152.5/1310
    Collections
    • UT Southwestern Electronic Theses and Dissertations

    UT Southwestern Health Sciences Digital Library and Learning Center | 5323 Harry Hines Boulevard, Dallas, Texas 75390-9049
    Telephone 214-648-2001 | Email
    Library Home | UT Southwestern Home
    DSpace software copyright © 2002-2016  DuraSpace
    Contact Us | Send Feedback
    TDL
    Theme by 
    Atmire NV
     

     

    Browse

    All of DSpaceCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    Login

    UT Southwestern Health Sciences Digital Library and Learning Center | 5323 Harry Hines Boulevard, Dallas, Texas 75390-9049
    Telephone 214-648-2001 | Email
    Library Home | UT Southwestern Home
    DSpace software copyright © 2002-2016  DuraSpace
    Contact Us | Send Feedback
    TDL
    Theme by 
    Atmire NV