It is increasingly recognized that cognitive symptoms are a common sequelae of relapsing-remitting multiple sclerosis and are associated with adverse functional consequences. However, estimates of cognitive impairment (CIm) prevalence vary widely. This study aimed to determine the pooled prevalence of CIm among adults with RRMS and investigate moderators of prevalence rates. Following prospective registration (PROSPERO; CRD42021281815), electronic databases (Embase, Scopus, Medline, and PsycINFO) were searched from inception until March 2023. Eligible studies reported the prevalence of CIm among adults with RRMS, as determined through standardized neuropsychological testing and defined as evidence of reduced performance across at least two cognitive domains (e.g., processing speed, attention) relative to normative samples, healthy controls, or premorbid estimates. The electronic database search yielded 8695 unique records, of which 50 met selection criteria. The pooled prevalence of cognitive impairment was 32.5% (95% confidence interval 29.3–36.0%) across 5859 participants. Mean disease duration and age were significant predictors of cognitive impairment prevalence, with samples with longer disease durations and older age reporting higher prevalence rates. Studies which administered more extensive test batteries also reported significantly higher cognitive impairment prevalence. Approximately one third of adults with RRMS experience clinical levels of CIm. This finding supports the use of routine cognitive testing to enable early detection of CIm, and to identify individuals who may benefit from additional cognitive and functional support during treatment planning.

人们越来越认识到认知症状是复发缓解型多发性硬化症的常见后遗症，并且与不良功能后果相关。然而，对认知障碍 (CIm) 患病率的估计差异很大。本研究旨在确定 RRMS 成人中 CIm 的汇总患病率，并调查患病率的调节因素。前瞻性注册（PROSPERO；CRD42021281815）后，从开始到 2023 年 3 月对电子数据库（Embase、Scopus、Medline 和 PsycINFO）进行了搜索。符合条件的研究报告了 RRMS 成人中 CIm 的患病率，通过标准化神经心理学测试确定并定义为相对于规范样本、健康对照或病前估计，至少两个认知领域（例如处理速度、注意力）表现下降的证据。电子数据库搜索产生了 8695 条独特记录，其中 50 条符合选择标准。 5859 名参与者中认知障碍的汇总患病率为 32.5%（95% 置信区间 29.3-36.0%）。平均病程和年龄是认知障碍患病率的重要预测因素，病程较长和年龄较大的样本报告患病率较高。进行更广泛的测试组的研究也报告了认知障碍患病率显着升高。大约三分之一患有 RRMS 的成年人经历过临床水平的 CIm。这一发现支持使用常规认知测试来早期发现 CIm，并确定在治疗计划期间可能受益于额外认知和功能支持的个体。