To develop international guidelines to assist in the identification of cognitive impairment (CI) among adult persons with MS (PwMS) for both clinical and research applications. The three topics addressed were: 1) cognitive screening, 2) cognitive measurement and diagnosis and 3) monitoring and diagnosing change over time.

CI occurs frequently in MS, is a common cause of loss of employment and has a significant impact on quality of life. The clinical onset and progression over time of CI can be insidious with disparate severity. Yet, studies to date use different definitions and cut-offs to define CI in PwMS, highlighting the need for clear criteria and guidelines.

The International Multiple Sclerosis Cognition Society (IMSCOGS) and European Committee for Treatment and Research in MS (ECTRIMS) partnered with the Cochrane Multiple Sclerosis and Rare Diseases of the CNS review group to conduct a scoping literature review to support the development of guidelines.  Based on this review, statements were formulated. Next, a modified Delphi approach was used to establish consensus via multiple virtual meetings and rounds of anonymous voting by a large group of clinical and research experts in this area with global representation. A minimum response and consensus of 80% was required for a statement to be accepted. Next, stakeholders and PwMS will provide feedback on the implication of these statements.

Our scoping review provided an evidence gap map, identifying key inconsistencies in the assessment of CI in PwMS. Delphi voting resulted in a clear set of criteria and guidelines. In this abstract, we will present the results on aims 2 and 3: cognitive measurement and diagnosis; monitoring/diagnosing change over time.

These guidelines permit reliable diagnosis of CI and cognitive decline in MS, allowing generalizability of research findings in future studies of CI in MS and consistency across research and clinical settings.