Cognitive impairment is a common problem in multiple sclerosis (MS); up to 65% of patients exhibit some neuropsychological dysfunction during the course of their disease. It is a major contributing factor to unemployment, accidents, impairment of daily functioning, and loss of social activity in those affected by MS. The areas of cognition typically impaired are memory, attention, information processing, executive functions, and visuospatial skills. Cognitive dysfunction is independent of disease duration and level of disability; cognitive decline may begin in the earliest stages of MS before patients become even mildly, disabled. Structural brain imaging studies show a positive correlation between the extent of brain atrophy and cognitive dysfunction. Despite its prevalence in MS, cognitive dysfunction often goes undiagnosed or is misdiagnosed as depression, stress, stubbornness, lack of intelligence, or psychosis. Because nurses play such an important role in the care of patients with MS, they are in a position to identify patients with cognitive dysfunction, educate patients and their families on ways to cope with cognitive deficits, and counsel patients on available treatment options. Practical guidelines help nurses identify and care for cognitively impaired MS patients.
Questions or comments about this article may be directed to: June Halper, MSCN ANP FAAN, by phone at 201/837–0727 or by e-mail at firstname.lastname@example.org. She is the executive director of the Consortium of Multiple Sclerosis Centers, Gimbel MS Center, Teaneck, NJ.
Patricia Kennedy, RN CNP MSCN. is a nurse practitioner at Rocky Mountain MS Center in Englewood, CO, and the Jimmie Heuga Center in Avon, CO.
Colleen Murphy Miller. RN NP DNS MSCN, is a nurse practitioner at The Jacobs Neurological Institute, The State University of New York at Buffalo, Buffalo, NY.
Linda Morgante, MSN RN CRRN MSCN, is a director of clinical services at Maimonides Medical Center, Brooklyn, NY.
Marie Namey, MSN RN MSCN, is an advanced practice nurse at the Cleveland Clinic Foundation, Cleveland, OH.
Amy Perrin Ross, MSN RN CNRN MSCN, is a program coordinator of neuroscience at Loyola University Medical Center. Maywood, IL.
© 2003 American Association of Neuroscience Nurses