Dementia and Multiple Sclerosis Among Nursing Home Residents

Suojin Wang, Ph.D.
Texas A&M University
P30ES09106

Background: Cognitive impairment, defined as a change in how a person thinks or reacts to his or her environment or emotions, may be a problematic symptom in multiple sclerosis (MS). MS is a chronic, slowly progressive autoimmune disease in which the body's immune system attacks the protective myelin sheaths that surround nerve cells of the brain and spinal cord which results in damaged areas that are unable to transmit nerve impulses. Epidemiologic research studies have estimated that 30-70% of people with MS have some form of cognitive impairment with 5-20% having severe problems. It is not clear whether the cognitive impairment is secondary to MS or is associated with other diseases such as Alzheimer's.

To gain a better understanding of what role dementia of any cause plays in the cognitive abilities of people with MS, this research team, which included an NIEHS-sponsored researcher at Texas A&M University, sought to characterize nursing home residents with MS and cognitive impairments and determine how they differ from residents with MS alone.

Advance: The results of the study show that nursing home residents with MS and dementia are admitted at an older age (approximately 10 years), are less likely to have physical impairments, but more likely to have mood and behavioral problems than other residents with MS. Previous research has proposed a "cortical variant" of MS characterized by progressive dementia and emotional disturbances with late onset of other neurological impairments leading to physical disability. It is not clear from the current study whether the dementia is associated with this form of MS or is related to other diseases.

Implications: The authors conclude that a cortical variant of MS may be more prevalent than previously suspected and may be an important factor in nursing home admissions in this group of patients; however the results of the study reported here do not enable them to reach this conclusion. They point out the need for additional clinical and imaging studies to reach a definitive determination.

Citation: Buchanan RJ, Martin RA, Moore L, Wang S, Ju H. Nursing home residents with multiple sclerosis and dementia compared to other multiple sclerosis residents. Mult Scler. 2005 Oct;11(5):610-6.