title: A longitudinal study of cognition in nursing home residents with multiple sclerosis.
abstract: OBJECTIVE
  Examine cognitive change in nursing home residents with multiple sclerosis (MS) over the first 4 years of their nursing home stay.
  
  
  METHODS
  Nine hundred and twenty-four individuals with MS in nursing homes were longitudinally studied. Of these, 121 had MS but no psychiatric or neurological co-morbidities, 169 had MS plus another neurological disorder (MS-Neuro), 269 had MS plus a psychiatric disorder (MS-Psych) and 365 had MS plus both psychiatric and neurological disorders (MS-Comb). Data were obtained from a large government data-set, the minimum data set (MDS), and cognition was rated on the MDS-Cognition Scale.
  
  
  RESULTS
  Data were analysed using a mixed-model ANOVA with a repeated factor of time and a fixed factor Group. We found a significant time effect with declines in cognition between each assessment, except 2000 and 2001, and a significant group effect so that the MS-Neuro and the MS-Comb groups had worse cognition than the MS-Psyc and the MS groups. A significant time x group interaction indicated differences in how the groups declined over time.
  
  
  CONCLUSIONS
  Over the first 4 years of a nursing home stay, cognition deteriorates in individuals with MS. Though there are not different rates of decline, residents with MS-Neuro and MS-Comb perform worse than residents with MS or MS-Psyc.
authors.affiliation: Psychology Department, University of North Carolina at Charlotte, Charlotte, North Carolina 28223-0001, USA. gdemakis@uncc.edu
authors.forename: George J
authors.initials: GJ
authors.lastname: Demakis
authors.forename: Robert
authors.initials: R
authors.lastname: Buchanan
authors.forename: Lloyd
authors.initials: L
authors.lastname: Dewald
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D009735:Nursing Homes