Comparing Cognitive Profiles of Older Patients with Multiple Sclerosis and Alzheimer Disease: Le Hua, MD

WATCH TIME: 5 minutes

"The surprising part was that not only did we see a processing speed difference in our patients with MS, but we also saw a lot of cortical differences in the major neurocognitive. So a lot more executive dysfunction than we would have thought based off of what we had already known about cognitive problems in MS. "

Approximately 65% of patients with multiple sclerosis (MS) experience disease-related cognitive impairment. Despite research progress, there is a lack of knowledge on cognitive issues among older patients with MS. In a recent retrospective observational study, findings showed that the overall characterization of the cognitive profile of MS may be different than previously described, involving both classically cortical and subcortical functions.¹ These results suggest that the distinction between the cognitive effects of MS and Alzheimer disease (AD) at more severe levels of cognitive impairment may be less reliable than thought before by clinicians.

Presented at the 2024 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 29 to March 2, participants in the study included those seen for routine clinical care at the Cleveland Clinic. Senior author Le Hua, MD, director of the Multiple Sclerosis Program at the Cleveland Clinic’s Lou Ruvo Center for Brain Health, and colleagues assembled 6 groups based on the results of their clinical workup and neuropsychological exam: cognitively normal, cognitively normal with MS, mild neurocognitive disorder, major neurocognitive disorder. Authors compared the groups in terms of cognitive test performance, percentage of the group impaired on specific cognitive skills, and rates of cognitive impairment.

Among 163 patients (MS, n = 85; matched from memory clinic, n = 78), differences between MS and AD were labeled in those with mild neurocognitive disorder. In those with major neurocognitive disorder, these differences disappeared except for persistent performance differences on a measure of rote verbal memory. At the forum, Hua sat down with NeurologyLive^® in an interview to discuss the risk of AD in older patients with MS. She also talked about the distinct differences in cognitive profiles between the two disorders. In addition, Hua spoke about the surprising revelations that surfaced concerning cognitive impairment in patients with MS compared with those who had AD.

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REFERENCES
1. Galioto R, Hancock L, Rhoads T, et al. Comparing Cognitive Profiles in Older Adults With Multiple Sclerosis and Alzheimer's Disease: More Similarities Than Differences. Presented at ACTRIMS Forum 2024; February 29 to March 2; West Palm Beach, Florida. P366.