Multiple sclerosis and related disorders · 2026
Using cognitive testing to predict employment status in multiple sclerosis: A comparative study of the SDMT and a computerized cognitive assessment tool.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Jackson Daija A, Bergmann Catherine S, Wilken Jeffrey, Weller Joanna, Zarif Myassar, Bumstead Barbara, Buhse Marijean, Jo Matthew, Barrera Marissa A, Penner Iris-Katharina, Morrow Sarah A, Hancock Laura M, Bogaardt Hans, Covey Thomas J, Doniger Glen M, Golan Daniel, Gudesblatt Mark
Аннотация
BACKGROUND: Cognitive impairment (CI) is prevalent in people with multiple sclerosis (PwMS) and influences employment outcomes independent of physical disability. Although associations between multi-domain CI and employment have been established, less is known about the relative clinical utility of brief cognitive screening tools versus time-efficient multi-domain computerized assessments that can be implemented in routine care.
OBJECTIVES: To compare the Symbol Digit Modality Test (SDMT) and NeuroTrax computerized cognitive battery (NT) as predictors of self-reported employment status in PwMS.
METHOD: 109 PwMS (Mean age = 48 years, SD = 10.4; 74 % female) completed the oral SDMT and NT as part of routine clinical care. Employment status was self-reported as "employed" or "unemployed" (including early retirement if <55 years).
RESULTS: When modeled separately, both the SDMT and NT Global Cognitive Score (GCS) significantly predicted employment status (p < .001). In the combined model, only the NT GCS remained a significant predictor (p = .036). Unemployed PwMS performed significantly worse on the SDMT, NT GCS, and all NT domains (p < .05). Effect sizes were largest for NT GCS (r = 0.401), executive function (r = 0.400), and the SDMT (r = 0.351). Unemployed PwMS were also more likely to exhibit CI across multiple domains (X2 (3) = 17.862, p < .001), with executive function and attention most frequently impaired.
CONCLUSION: While the SDMT remains a useful screening tool, the NT appears clinically feasible for use in routine care and provides incremental and domain-specific information beyond processing speed alone. Extending assessment in routine care beyond a single screening measure may better characterize cognitive profiles associated with unemployment and inform individualized vocational interventions in PwMS.
OBJECTIVES: To compare the Symbol Digit Modality Test (SDMT) and NeuroTrax computerized cognitive battery (NT) as predictors of self-reported employment status in PwMS.
METHOD: 109 PwMS (Mean age = 48 years, SD = 10.4; 74 % female) completed the oral SDMT and NT as part of routine clinical care. Employment status was self-reported as "employed" or "unemployed" (including early retirement if <55 years).
RESULTS: When modeled separately, both the SDMT and NT Global Cognitive Score (GCS) significantly predicted employment status (p < .001). In the combined model, only the NT GCS remained a significant predictor (p = .036). Unemployed PwMS performed significantly worse on the SDMT, NT GCS, and all NT domains (p < .05). Effect sizes were largest for NT GCS (r = 0.401), executive function (r = 0.400), and the SDMT (r = 0.351). Unemployed PwMS were also more likely to exhibit CI across multiple domains (X2 (3) = 17.862, p < .001), with executive function and attention most frequently impaired.
CONCLUSION: While the SDMT remains a useful screening tool, the NT appears clinically feasible for use in routine care and provides incremental and domain-specific information beyond processing speed alone. Extending assessment in routine care beyond a single screening measure may better characterize cognitive profiles associated with unemployment and inform individualized vocational interventions in PwMS.