title: Feasibility study for remote assessment of cognitive function in multiple sclerosis.
abstract: BACKGROUND
  Cognitive impairment is common in multiple sclerosis (MS), and affects employment and quality of life. Large studies are needed to identify risk factors for cognitive decline. Currently, a MS-validated remote assessment for cognitive function does not exist. Studies to determine feasibility of large remote cognitive function investigations in MS have not been published.
  
  
  OBJECTIVE
  To determine whether MS patients would participate in remote cognitive studies. We utilized the Modified Telephone Interview for Cognitive Status (TICS-M), a previously validated phone assessment for cognitive function in healthy elderly populations to detect mild cognitive impairment. We identified factors that influenced participation rates. We investigated the relationship between MS risk factors and TICS-M score in cases, and score differences between cases and control individuals.
  
  
  METHODS
  The TICS-M was administered to MS cases and controls. Linear and logistic regression models were utilized.
  
  
  RESULTS
  11.5% of eligible study participants did not participate in cognitive testing. MS cases, females and individuals with lower educational status were more likely to refuse (p<0.001). Cases who did complete testing did not differ in terms of perceived cognitive deficit compared to cases that did participate. More severe disease, smoking, and being male were associated with a lower TICS-M score among cases (p<0.001). The TICS-M score was significantly lower in cases compared to controls (p=0.007).
  
  
  CONCLUSIONS
  Our results demonstrate convincingly that a remotely administered cognitive assessment is quite feasible for conducting large epidemiologic studies in MS, and lay the much needed foundation for future work that will utilize MS-validated cognitive measures.
authors.affiliation: Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Michaela F
authors.initials: MF
authors.lastname: George
authors.affiliation: Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Calliope B
authors.initials: CB
authors.lastname: Holingue
authors.affiliation: Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Farren B S
authors.initials: FB
authors.lastname: Briggs
authors.affiliation: Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Shao
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA, USA.
authors.forename: Kalliope H
authors.initials: KH
authors.lastname: Bellesis
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA, USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Whitmer
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Schaefer
authors.affiliation: Jacobs MS Center, SUNY Buffalo School of Medicine, Buffalo, NY, USA.
authors.forename: Ralph Hb
authors.initials: RH
authors.lastname: Benedict
authors.affiliation: Division of Epidemiology, Genetic Epidemiology and Genomics Laboratory, School of Public Health, University of California, Berkeley, CA, USA; Kaiser Permanente Division of Research, Oakland, CA, USA.
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Barcellos
keywords: Autoimmune disease; Case control studies; Cognitive impairment; HLA-DRB1; Multiple Sclerosis Severity Score; Multiple sclerosis; PDQ; TICS-M