With the proposal of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, the need to screen for cognitive deficits within standard clinical care of patients with multiple sclerosis (MS) has been acknowledged. Data regarding how patient characteristics might predict low cognitive performance and therefore require particularly close monitoring is, however, limited so far. We investigated a large, nationwide patient cohort from ambulatory settings, representing the typical distribution of different subtypes, levels of physical disability, and disease durations. Besides cognitive testing with BICAMS, additional sampling of multiple demographics and clinical variables allowed us to characterize general and domain‐specific prevalence patterns of cognitive impairment (CI) as well as to delineate which factors are associated with cognitive performance. In a total of 1,094 patients, CI was present in 28% (using a conservative cut‐off of the 5th percentile below normative values), with information‐processing speed being most frequently affected. Impairment was overall higher in patients with primary progressive (PPMS) and secondary progressive MS than in patients with relapsing–remitting (RR)MS. Regression modelling revealed that disease subtype (i.e., PPMS), long disease duration, high physical disability, unemployment, low educational level, high age, male sex, and the absence of current disease‐modifying treatment were important predictors for worse BICAMS’ test performance. These results emphasize the importance of continuous cognitive assessment during regular neurological follow‐up visits, with a particular focus on patients being identified as high‐risk subjects for CI according to the reported factors.

中文翻译：

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表征多发性硬化症的认知缺陷和潜在预测因素：一项大型全国性研究，在标准临床护理中应用多发性硬化症的简要国际认知评估。

随着多发性硬化症简要国际认知评估 (BICAMS) 电池组的提议，已经认识到需要在多发性硬化症 (MS) 患者的标准临床护理中筛查认知缺陷。然而，到目前为止，关于患者特征如何预测低认知能力并因此需要特别密切监测的数据是有限的。我们调查了来自门诊环境的大型全国患者队列，代表不同亚型、身体残疾水平和疾病持续时间的典型分布。除了使用 BICAMS 进行认知测试，对多个人口统计学和临床​​变量的额外抽样使我们能够表征认知障碍 (CI) 的一般和特定领域的流行模式，以及描绘哪些因素与认知表现相关。在总共 1,094 名患者中，CI 占 28%（使用低于规范值的第 5 个百分位数的保守截止值），信息处理速度最常受到影响。原发性进展性 (PPMS) 和继发性进展性 MS 患者的损伤总体上高于复发缓解型 (RR) MS 患者。回归模型显示疾病亚型（即 PPMS）、病程长、身体残疾率高、失业、教育水平低、年龄高、男性、和当前疾病改善治疗的缺乏是 BICAMS 测试性能较差的重要预测因素。这些结果强调了在定期神经病学随访期间持续认知评估的重要性，特别关注根据报告的因素被确定为 CI 高风险受试者的患者。