Multiple Sclerosis Journal
1–7
DOI: 10.1177/
1352458515593637
© The Author(s), 2015.
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MULTIPLE
SCLEROSIS MSJ
JOURNAL
http://msj.sagepub.com 1
Introduction
Multiple sclerosis (MS) results in motor, cognitive,
and neuropsychiatric symptoms, all of which can
occur independently of one another at all disease
stages and in all MS subtypes.
1
Common cognitive
symptoms include deficits in complex attention, exec-
utive functioning, processing speed, and long-term
memory.
1
Various instruments are used to measure
one or more domains of cognitive impairments in MS,
such as the minimal assessment of cognitive function
in MS (MACFIMS)
2
and brief repeatable battery of
NP tests (BRB-N).
3,4
Recently, a brief cognitive
assessment for MS (Brief International Cognitive
Assessment for MS: BICAMS) has been recom-
mended for use to screen for cognitive impairments,
because it addresses some of the needs in clinical
practice. The battery is short, has established validity
and reliability, captures the cognitive performance of
MS patients, and can be administered by healthcare
professionals who do not need special training.
5,6
To date, few studies have been conducted that have
found a strong association between cognitive ability
and daily functioning.
7–9
Given the high incidence of
cognitive deficits in MS, clearly elucidating the rela-
tionship between cognitive abilities and daily life
functioning for patients with MS is of critical impor-
tance, particularly for the clinician in a busy practice.
In this setting, subjective self-reports of cognitive
abilities, everyday life, and/or QOL are often utilized.
Such subjective reports are minimally associated with
actual cognitive impairment
10,11
and generally unre-
lated to actual everyday life activity.
7–9,12
Use of a
brief cognitive assessment such as BICAMS may
provide an objective, reliable means of inferring the
impact of the disease on cognitive skills and daily life
Brief International Cognitive Assessment for
Multiple Sclerosis (BICAMS) and performance
of everyday life tasks: Actual Reality
Yael Goverover, Nancy Chiaravalloti and John DeLuca
Abstract
Background: Recently, a brief cognitive assessment (Brief International Cognitive Assessment for
Multiple Sclerosis: BICAMS) has been recommended for use with patients diagnosed with multiple scle-
rosis (MS) to screen for cognitive impairments. However, the relationship between the BICAMS and
everyday life activity has not been examined. The aim of this study was to examine whether the BICAMS
can predict performance of activities of daily living using Actual Reality
TM
(AR) in persons with MS.
Method: A between-subjects design was utilized to compare 41 individuals with MS and 32 healthy
controls (HC) performing BICAMS and an AR task. Participants were asked to access the internet to
purchase a flight ticket or cookies, and were administered the BICAMS and questionnaires to assess
quality of life (QOL), affect symptomatology, and prior internet experience.
Results: Participants with MS performed significantly worse than HC on the BICAMS and the AR.
Additionally, better BICAMS performance was associated with more independent AR performance. Self-
reports of QOL were not correlated with AR or BICAMS performance.
Conclusions: Individuals with MS have greater problems with actual everyday life tasks as compared
to HC. The BICAMS is a promising cognitive screening tool to predict actual functional performance in
participants with MS.
Keywords: Cognition, activities of daily living, quality of life, multiple sclerosis, outcome measurement
Date received: 29 January 2015; revised: 26 May 2015; accepted: 4 June 2015
Correspondence to:
Yael Goverover
Department of Occupational
Therapy, Steinhardt School
of Culture, Education,
and Human Development,
New York University, 82
Washington Square East,
6
th
floor, New York, NY
10003, USA.
yg243@nyu.edu
Yael Goverover
Department of Occupational
Therapy, Steinhardt School
of Culture, Education, and
Human Development, New
York University, USA
Nancy Chiaravalloti
Kessler Foundation, West
Orange, NJ, USA Department
of Physical Medicine and
Rehabilitation, New Jersey
Medical School, Rutgers
University, USA
John DeLuca
Kessler Foundation,
West Orange, NJ USA;
Department of Physical
Medicine and Rehabilitation,
New Jersey Medical School,
Rutgers University, USA
593637MSJ 0 0 10.1177/1352458515593637Multiple Sclerosis JournalGoverover
research-article 2015
Original Research Paper
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