Cognitive performance may predict self-management in patients with multiple sclerosis (MS), a study published in Multiple Sclerosis and Related Disorders suggests. Patients with poor self-management can develop several complications in the long run.

The definition of self-management varies greatly. Generally speaking, it entails a patient who actively participates in the approach to managing their MS. The patient may seek information on the disease, partake in treatment decisions, handle symptoms related to MS, and maintain social relations with emotional equilibrium.

Currently, MS patients with problems regarding self-management are at risk of low rehabilitation efficacy, higher healthcare costs, and worse long-term complications. 

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Patients with MS typically suffer from neurologic symptoms, but they can also experience cognitive impairment. The authors wanted to determine if cognitive functioning was related to self-management in patients with MS. 

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The researchers included 194 patients, 50 of whom were male, with MS diagnosed according to the 2017 revised McDonald criteria. The mean age was almost 39 years, and the exclusion criteria comprised relapse or treatment change within 3 months, pregnancy, and psychiatric or metabolic disease. 

Nearly 90% of the patients had a relapsing-remitting MS disease course, while the remainder had progressive MS. The median disease duration was 8 years, and the median Expanded Disability Status Scale (EDSS) score was 2.0.

The study team used the Multiple Sclerosis Self-Management Scale-Revised (MSSM-R) to measure each patient’s self-management level and the Multiple Sclerosis Inventory Cognition Scale (MUSIC) to assess overall cognitive performance and fatigue.

They found a positive correlation between the MSSM-R and MUSIC cognitive scores. They also found a negative correlation between the MSSM-R and MUSIC fatigue scores. 

In a hierarchical regression analysis, they also found that higher income levels and cognitive performance were significantly associated with more satisfactory self-management in patients with MS. 

“Our results suggest that cognitive performance is a predictor of self-management,” the authors noted. “Additionally, the results highlight [the] relationship between self-management in MS and income level.”

The authors stated that despite cognitive function being shown to influence self-management in other chronic diseases, this was the first study directly assessing this link in patients with MS. They suggest the finding will enable the tailoring of self-management training programs for each patient.


Efendi H, Ünal A, Akçalı A, et al. The effect of cognitive performance on self-management behavior of multiple sclerosis patientsMult Scler Relat Disord. Published online May 18, 2022. doi:10.1016/j.msard.2022.103880