title: Is the concept of quality of life relevant for multiple sclerosis patients with cognitive impairment? Preliminary results of a cross-sectional study.
abstract: BACKGROUND
  Cognitive impairment occurs in about 50% of multiple sclerosis (MS) patients, and the use of self-reported outcomes for evaluating treatment and managing care among subjects with cognitive dysfunction has been questioned. The aim of this study was to provide new evidence about the suitability of self-reported outcomes for use in this specific population by exploring the internal structure, reliability and external validity of a specific quality of life (QoL) instrument, the Multiple Sclerosis International Quality of Life questionnaire (MusiQoL).
  
  
  METHODS
  
  
  
  METHODS
  cross-sectional study.
  
  
  METHODS
  MS patients of any disease subtype.
  
  
  METHODS
  sociodemographic (age, gender, marital status, education level, and occupational activity) and clinical data (MS subtype, Expanded Disability Status Scale, disease duration); QoL (MusiQoL and SF36); and neuropsychological performance (Stroop color-word test).
  
  
  METHODS
  confirmatory factor analysis, item-dimension correlations, Cronbach's alpha coefficients, Rasch statistics, relationships between MusiQoL dimensions and other parameters.
  
  
  RESULTS
  One hundred and twenty-four consecutive patients were enrolled. QoL scores did not differ between the 69 cognitively non-impaired patients and the 55 cognitively impaired patients, except for the symptoms dimension. The confirmatory factor analysis performed among the impaired subjects showed that the structure of the questionnaire matched with the initial structure of the MusiQoL. The unidimensionality of the MusiQoL dimensions was preserved, and the internal validity indices were satisfactory and close to those of the reference population.
  
  
  CONCLUSIONS
  Our study suggests that executive dysfunction did not compromise the reliability and the validity of the self-reported QoL questionnaires.
authors.affiliation: EA3279 Self-Perceived Health Assessment Research Unit and Department of Public Health, Nord University Hospital, APHM, Marseille, France. karine.baumstarck@univmed.fr
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.forename: Jean
authors.initials: J
authors.lastname: Pelletier
authors.forename: Valérie
authors.initials: V
authors.lastname: Aghababian
authors.forename: Françoise
authors.initials: F
authors.lastname: Reuter
authors.forename: Irina
authors.initials: I
authors.lastname: Klemina
authors.forename: Julie
authors.initials: J
authors.lastname: Berbis
authors.forename: Anderson
authors.initials: A
authors.lastname: Loundou
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000150:complications* / Q000503:physiopathology; D003210:Concept Formation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards