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Medical Decision-Making in Progressive MS

J Neurol Sci; ePub 2017 Jun 29; Gerstenecker, et al

Medical decision-making capacity (MDC) is a complex and cognitively mediated functional ability that is impaired in many people with progressive multiple sclerosis (MS), a recent study found. Verbal measures of fluency and memory are strongly associated with MDC performances in the current sample of people with MS and could potentially be utilized to quickly screen for MDC impairment in MS. Data from 22 persons with progressive MS and 18 healthy controls were analyzed. All diagnoses were made by a board-certified neurologist with experience in MS. All study participants were administered a vignette-based measure of MDC and also a neuropsychological battery. Researchers found:

  • Performance on 3 MDC consent standards (ie, appreciation, reasoning, understanding) was significantly lower for people with progressive MS as compared to healthy controls.
  • In the progressive MS group, verbal fluency was the primary cognitive predictor for both reasoning and understanding consent standards.
  • Verbal learning and memory was the primary cognitive predictor for appreciation.
  • MS severity was not significantly correlated with any MDC variable.

Citation:

Gerstenecker A, Lowry K, Myers T, et al. Medical decision-making capacity and its cognitive predictors in progressive MS: Preliminary evidence. [Published online ahead of print June 29, 2017]. J Neurol Sci. doi:10.1016/j.jns.2017.06.047.