Fraser Cira, Stark Sharon
Marjorie K. Unterberg School of Nursing at Monmouth University, West Long Branch, NJ, USA.
J Neurosci Nurs. 2003 Dec;35(6):314-20. doi: 10.1097/01376517-200312000-00005.
There are inconsistencies in the literature regarding the prevalence of cognitive impairment among individuals with multiple sclerosis (MS). The purpose of this study was to examine perceived cognitive impairment in secondary progressive and relapsing-remitting multiple sclerosis (MS) and to examine the relationship between level of disability, age, and number of years with MS and self-reported cognitive symptoms. The sample consisted of 447 individuals (96 participants with secondary progressive MS and 351 participants with MS) who responded to mailed data collection instruments. The Performance Scales, a self-report measure of disability in eight domains of function, and a sociodemographic data sheet were analyzedfor this study. Of individuals with secondary progressive MS, 83% reported cognitive symptoms, while 82% of individuals with relapsing-remitting MS reported cognitive symptoms. Individuals with secondary progressive MS were reportedly experiencing a significantly greater level of total disability. A statistically significant, strong, positive relationship was found between cognitive symptoms and fatigue for those with secondary progressive MS and those with relapsing-remitting MS. Statistically significant, moderate, positive relationships were also found between cognitive symptoms in those with secondary progressive MS and those with relapsing-remitting MS, and sensory symptoms, vision, hand function, bladder/bowel symptoms, and spasticity. A statistically significant, weak, positive relationship was found between cognitive symptoms and mobility in individuals with relapsing-remitting MS. There was no relationship between cognitive symptoms and mobility in those with secondary progressive MS. Cognitive symptoms were not significantly related to age in those with secondary progressive MS or those with relapsing-remitting MS. In addition, cognitive symptoms were not significantly related to the number of years with MS in individuals with secondary progressive MS or those with relapsing-remitting MS. The perception of cognitive deficits in individuals with MS was found in this study to be even more prevalent than previously reported. Because cognitive deficits occur at all stages of MS, early identification and treatment is essential. Healthcare providers must aggressively screen for cognitive impairment and rehabilitate individuals with MS who exhibit symptoms.
关于多发性硬化症(MS)患者中认知障碍的患病率,文献中存在不一致之处。本研究的目的是调查继发进展型和复发缓解型多发性硬化症(MS)患者中感知到的认知障碍情况,并研究残疾程度、年龄、患MS的年限与自我报告的认知症状之间的关系。样本包括447名个体(96名继发进展型MS参与者和351名MS参与者),他们对邮寄的数据收集工具进行了回应。本研究分析了功能的八个领域中残疾情况的自我报告测量工具——表现量表,以及一份社会人口数据表。继发进展型MS患者中,83%报告有认知症状,而复发缓解型MS患者中82%报告有认知症状。据报告,继发进展型MS患者的总体残疾程度明显更高。在继发进展型MS患者和复发缓解型MS患者中,均发现认知症状与疲劳之间存在统计学上显著的、强烈的正相关关系。在继发进展型MS患者和复发缓解型MS患者中,还发现认知症状与感觉症状、视力、手部功能、膀胱/肠道症状及痉挛之间存在统计学上显著的、中等程度的正相关关系。在复发缓解型MS患者中,发现认知症状与活动能力之间存在统计学上显著的、微弱的正相关关系。在继发进展型MS患者中,认知症状与活动能力之间没有关系。在继发进展型MS患者或复发缓解型MS患者中,认知症状与年龄均无显著相关性。此外,在继发进展型MS患者或复发缓解型MS患者中,认知症状与患MS的年限也无显著相关性。本研究发现,MS患者中认知缺陷的感知比之前报道的更为普遍。由于认知缺陷发生在MS的各个阶段,早期识别和治疗至关重要。医疗保健提供者必须积极筛查认知障碍,并对出现症状的MS患者进行康复治疗。