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Diabetes and Anxiety Affect Cognition in MS

Mult Scler Relat Disord; ePub 2018 Oct 23; Marrie, et al

Comorbidities, including diabetes and anxiety, are associated with cognitive dysfunction in multiple sclerosis (MS), according to a recent study. Their presence may contribute to the heterogeneous pattern of impairments seen across individuals and they may represent targets for improved management of cognitive symptoms. Participants completed a structured psychiatric interview, the Hospital Anxiety and Depression Scale (HADS), a comorbidity questionnaire, and cognitive testing including the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test (CVLT-II), Brief Visuospatial Memory Test-Revised (BVMT-R), and verbal fluency. Test scores were converted to age-, sex- and education-adjusted z-scores. Researchers found:

  • Of 111 participants, most were women (82.9%) with relapsing remitting MS (83.5%), of mean (SD) age 49.6 (12.7) years.
  • Comorbidity was common; 22.7% participants had hypertension, 10.8% had diabetes, 9.9% had current major depression, and 9.9% had current anxiety disorders.
  • Diabetes and anxiety disorder were associated with cognitive function overall.
  • Diabetes was associated with lower BVMT-R (β=-1.18) and fluency (β=-0.63) z-scores.
  • Anxiety was associated with lower SDMT (β=-1.07) z-scores.
  • Elevated anxiety symptoms (HADS-A≥ 11) were associated with lower z-scores on the SDMT and CVLT-II.


Marrie RA, Patel R, Figley CR, et al, for the Comorbidity and Cognition in Multiple Sclerosis (CCOMS) Study Group. [Published online ahead of print October 23, 2018]. Mult Scler Relat Disord. doi:10.1016/j.msard.2018.10.018.

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