Sage Journals: Discover world-class research

Abstract

Multiple sclerosis (MS) has important effects on quality of life but it is unknown how cognitive impairment affects the ability to assess or report this. O ur objective was to determine whether cognitive impairment negatively affects the construct validity and the reliability of the Multiple Sclerosis Q uality of Life Inventory (MSQLI). A neuropsychological test batter y and the Multiple Sclerosis Functional C omposite (MSFC) were administered to a sample of 136 patients referred for cognitive testing by their neurologists. A ge, sex, educatio n and ethnicity-adjusted T scores were calculated for each cognitive variable. C ognitive impairment was defined as any T score less than the fifth percentile. The MSQ LI was administered prior to neuropsychological testing and readministered one to four weeks later. C orrelations between the MSFC and the SF-36 were determined and compared between the cognitively impaired and unimpaired groups as the main test of construct validity. Test -retest and internal consistency reliability of each of the scales were compared for the impaired and unimpaired groups. Seventy-six (56%) patients were cognitively impaired. C onstruct validity and internal consistency reliability did not differ between the cognitively impaired and unimpaired groups. Test -retest reliability was lower for the bladder and vision scales in the impaired group, but remained acceptable for the bladder scale (r >0.7). C ognitive impairment, a common MS manifestation, does not appear to reduce the reliability or validity of the MSQ LI as a patient self-report measure of health status and quality of life.

Keywords

co gnition health-related quality of life MSQ LI multiple sclerosis reliability self-report validity

Get full access to this article

View all access options for this article.

References

Cella DF , Dineen K , Arnason B , Reder A. Validation of the Functional Assessment of Multiple Sclerosis quality of life instrument . Neurology 1996; 47: 129-139 .

Brunet DG , Hopman WM , Singer MA , Edgar CM , MacKenzie TA. Measurement of health-related quality of life in multiple sclerosis patients . Can J Neurol Sci 1996; 23: 99-103 .

Nortvedt MW , Riise T , Myhr K-M , Nyland HI. Quality of life in multiple sclerosis: measuring the disease effects more broadly . Neurology 1999; 53: 1098-1103 .

Canadian Burden of Illness Study Group . Burden of illness of multiple sclerosis: Part II: quality of life . Can J Neurol Sci 1998; 25: 31-38 .

Hermann B , Vickrey B , Hays RD , Cramer J , Devinsky O , Meador K et al. A comparison of health-related quality of life in patients with epilepsy, diabetes and multiple sclerosis . Epilepsy Res 1996; 25: 113-118 .

Rudick RA , Miller DM , Clough JD , Gragg LA , Farmer RG. Quality of life in multiple sclerosis: Comparison with inflammatory bowel disease and rheumatoid arthritis . Arch Neurol 1992; 49: 1237-1242 .

Fischer JS , LaRocca NG , Miller DM , Ritvo PG , Andrews H , Paty DW. Recent developments in the assessment of quality of life in multiple sclerosis (MS) . Mult Scler 1999; 5: 251-259 .

Cohen JA , Cutter GR , Fischer JS , Goodman AD , Heidenreich FR , Kooijmans MF et al. benefit of interferon beta-1a on MSFC progression in secondary progressive MS . Neurology 2002; 59: 679-687 .

Amato MP , Giuseppina P , Pracucci G , Bracco L , Siracusa G , Amaducci L. Cognitive impairment in early-onset multiple sclerosis: patterns, predictors, and impact on everyday life in a 4-year follow-up . Arch Neurol 1995; 52: 168-172 .

10.

Beatty WW , Goodkin DE , Hersgaard D , Monson N.

Clinical and demographic predictors of cognitive performance in multiple sclerosis: do diagnostic type, disease duration, and disability matter?

Arch Neurol 1990; 47: 305-308 .

11.

Lyon-Caen O , Jouvent R , Hauser S , Caunu M , Benoit N , Widlocher D et al. Cognitive function in recent-onset demyelination disease . Arch Neurol 1986; 43: 1138-1141 .

12.

Peyser JM , Edwards KR , Poser CM , Filskov SB. Cognitive function in patients with multiple sclerosis . Arch Neurol 1980; 37: 577-579 .

13.

Rao SM , Leo GJ , Bernardin L , Unverzagt F. Cognitive dysfunction in multiple sclerosis I: frequency, patterns, and predictions . Neurology 1991; 41: 685-691 .

14.

Kenealy PM , Beaumont JG , Lintern T , Murrell R. Autobiographical memory, depression and quality of life in multiple sclerosis . J Clin Exp Neuropsychol 2000; 22: 125-131 .

15.

McDonald WI , Compston A , Edan G , Goodkin D , Hartung H-P , Lublin FD et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis . Ann Neurol 2001; 50: 121-127 .

16.

Benedict RHB , Fischer JS , Archibald CJ , Arnett PA , Beatty WW , Bobholz J et al. Minimal neuropsychological assessment of MS patients: a consensus approach . Clin Neuropsychol 2002; 16: 381-397 .

17.

Taylor MJ , Heaton RK. Sensitivity and specificity of WAIS-III/WMS-III demographically corrected factor scores in neuropsychological assessment . J Int Neuropsychol Soc 2001; 7: 867-874 .

18.

Ritvo PG , Fischer JS , Miller DM , Andrews H , Paty DW , LaRocca NG. Multiple sclerosis quality of life inventory: a user’s manual. National Multiple Sclerosis Society , 1997.

19.

Rothwell PM , McDowell Z , Wong CK , Dorman PJ. Doctors and patients don’t agree: cross-sectional study of patients’ and doctors’ perceptions and assessments of disability in multiple sclerosis . BMJ 1997; 314: 1580-1583 .

20.

Sprangers MA , Aronson NK. The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review . J Clin Epidemiol 1992; 45: 743-760 .

21.

Miller DM , Rudick RA , Cutter G , Baier M , Fischer JS. Clinical significance of the Multiple Sclerosis Functional Composite: relationship to patient-reported quality of life . Arch Neurol 2000; 57: 1319-1324 .

22.

Cronbach LJ. Coefficient alpha and the internal structure of tests . Psychometrika 1951; 16: 297-334 .

23.

Hakstian AR , Whalen TE. A k-sample significance test for independent alpha coefficients . Biometrika 1976; 41: 219-231 .

24.

Fischer JS , Jak AJ , Kniker JE , Rudick RA , Cutter G. Administration and scoring manual for the Multiple Sclerosis Functional Composite measure (MSFC). National Multiple Sclerosis Society , 2001.

25.

Lublin FD , Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey . Neurology 1996; 46: 907-911 .

26.

SAS Institute Inc. SAS V8.2. 1999.

27.

Baier ML , Miller DM. How consistent is self-reported health-related quality of life in the face of cognitive impairment in MS patients . Presented at International Society for Quality of Life Research, 7 -10 November, Amsterdam, The Netherlands, 2001.

28.

Logsdon RG , Gibbons LE , McCurry SM , Teri L. Assessing quality of life in older adults with cognitive impairment . Psychosomatic Med 2002; 64: 510-519 .

29.

Fisk JD , Pontefract A , Ritvo PG , Archibald CJ , Murray TJ. The impact of fatigue on patients with multiple sclerosis . Can J Neurol Sci 1994; 21: 9-14 .

30.

Nowinski JK , LoPiccolo J. Assessing sexual behavior in couples . J Sex Marital Ther 1979; 5: 224-243 .

31.

Sherbourne CD , Stewart AL. The MOS Social Support Survey . Soc Sci Med 1991; 32: 705-714 .

32.

Stewart AL , Ware JE. Measuring functioning and well-being: the Medical Outcomes Study Approach. Durham, NC: Duke University Press , 1992.

33.

Turnball GK , Hoare C , Ritvo PG , Fisk JD , Murray TJ. The assessment of bowel and bladder dysfunction in clinic attending MS patients . Presented at Department of Medicine Research Symposium, Dalhousie University, Halifax, Nova Scotia, May 1993.

34.

Sullivan JJL , Edgley K , Dehoux E. A survey of multiple sclerosis Part 1: perceived cognitive problems and compensatory strategy use . Can J Rehab 1990; 4: 99-105 .

Validity and reliability of the MSQ LI in cognitively impaired patients with multiple sclerosis

Abstract

Keywords

Get full access to this article

References