Perceptions of Patients With MS and Caregivers on Daily Activity Performance

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An evaluation of cognitive function measurements, performance in daily activities, and the perception of cognitive functions in patients with multiple sclerosis (MS) found caregiver perceptions more closely correlate with the test measurements than patient perceptions.

While there has been an increasing amount of attention paid to cognitive impairment in multiple sclerosis (MS) and the importance of routine evaluation of cognitive function in patients with MS, evaluations should also include the caregiver’s perceptions.

A new study, published in BMS Neurology, evaluated the relationship between cognitive function measured by tests, performance in daily activities, and the perception of cognitive function in patients with MS and their caregivers.

“In addition to motor involvement, other clinical manifestation significantly affects the quality of life of patients and their caregivers, including fatigue, pain, dysphagia, psychiatric disorders, and cognitive deficits,” the authors wrote.


The researchers recruited 49 patients with a diagnosis of MS and their caregivers (1 caregiver per patient). They created a questionnaire to evaluate performance in daily activities that do not require specific motor functions. Participants were asked to indicate if they were able to do certain activities with no difficulties, some difficulties, or if they found them impossible to do in the last year. Some of the activities on the list included making a shopping list, sending an email, making a withdrawal at an ATM, or using social networks.

In addition, cognitive function was evaluated using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), and perception of cognitive function was evaluated using the Multiple Sclerosis Neuropsychological Questionnaire for patients (pMSNQ) and caregivers (cgMSNQ).

While there was a significant correlation between the BICAMS scores and both versions of the MSNQ, the cgMSNQ was more strongly correlated than the pMSNQ. According to the authors, the results highlight the importance of involving the caregiver in evaluations of cognitive deficits.

“In fact, the caregiver point of view may be a real expression of cognitive deficit more than patients’ perception,” the authors noted.

Some of the limitations of the study included the fact that the MSNQ was translated into Italian, as there is no Italian version available. In addition, the authors did not find appropriate tools in the literature to adequately evaluate performance on daily activities that did not require motor skills, which is why they created an ad hoc test.

“In conclusion, although our findings require further study in order to be generalized, they offer several insights as to the perception of cognitive deficits in MS and the correlation between objective cognitive deficits and the actual impact on activities in daily life,” the authors wrote.


Fenu G, Fronza M, Lorefice L, et al. Performance in daily activities, cognitive impairment and perception in multiple sclerosis patients and their caregivers. BMC Neurology. 2018;18:212.