IDENTIFYING MULTIPLE-SCLEROSIS PATIENTS WITH MILD OR GLOBAL COGNITIVE IMPAIRMENT USING THE SCREENING EXAMINATION FOR COGNITIVE IMPAIRMENT (SEFCI)

Cognitive impairment affects 40 to 70% of patients with multiple sclerosis (MS), but its occurrence cannot be predicted from knowledge of the individual patient's age, level of physical disability, duration of disease, disease type, or performance on standard mental status examinations. To evaluate the usefulness of a brief screening battery, the Screening Examination for Cognitive Impairment (SEFCI), 103 community-dwelling MS patients and 32 healthy normal controls received the SEFCI and a 2-hour battery of other neuropsychological tests chosen for their sensitivity to the cognitive impairments most often observed in MS. Performance on the SEFCI correctly identified 86% of the patients with impairment on any of the 11 measures from the longer battery, 100% of the patients with impairments in at least three cognitive domains, and 90% of the patients without cognitive impairment. Because the SEFCI is sensitive, specific, and easily administered and scored, it should aid the physician in deciding whether to refer an MS patient for a complete evaluation.