Cognitive Performance and Wellbeing Correlates with Stigma and EDSS in Caribbean Hispanic Patients with Multiple Sclerosis
Janice Vargas1, Gabriela Betances-Arroyo2, Edgar Castillo Meléndez2, Bexaida Diaz-Perez3, Gishlaine Alfonso1, Valerie Wojna1
1Neurology, 2School of Medicine, University of Puerto Rico Medical Sciences Campus, 3University of Puerto Rico Medical Sciences Campus
Objective:
Our previous study showed significant correlations between stigma, disease severity, and quality of life (QoL) in a Caribbean Hispanic population with a diagnosis of multiple sclerosis (MS). The purpose of this study is to evaluate further if stigma correlates with cognitive performance and well-being in our patients with MS.
Background:
Multiple Sclerosis is a chronic and progressive condition that is associated with a variable clinical presentation. Recently, cognitive performance has come to the forefront of investigative studies in the MS patient population. Additionally, association to variables such as psychological wellbeing has been described. However, the correlation between stigma, cognitive performance, and wellbeing needs further investigation.
Design/Methods:
A prospective study of 29 participants with MS was recruited from our Neurology Clinics at the University of Puerto Rico. All participants were evaluated for demographic data, EDSS, cognitive performance with BVMT-R, and the NIH Toolbox questionnaire for positive affect and wellbeing. T scores were used for the correlation analysis.
Results:
We observed a negative correlation between stigma and BVMT-R total recall and learning (p<0.001) and a positive correlation between stigma with delayed recall (p<0.05) and percent retained (p<0.001). Interestingly we also observed a negative correlation between BVMT-R total recall, delayed recall, and percent retained T scores with EDSS (p<0.001). Contrary to what was expected, there was a positive correlation between psychological well-being and EDSS (p<0.001).
Conclusions:
Higher levels of stigma correlated with poor cognitive performance as determined by BVMT-R. Additionally, poor cognitive performance in domains such as total recall, delayed recall, and percent retained appear to be related to disease severity. The positive correlation between wellbeing and EDSS needs further investigation. Therefore, it is imperative to develop strategies to mitigate stigma and improve cognitive performance to work towards prevention of disability and improvement of QoL.