Cognitive impairment in multiple sclerosis: The role of the general practitioner in cognitive screening and care coordination

Background: Cognitive impairment is common in multiple sclerosis (MS) and can have an impact on all aspects of daily life. It is also an early marker of increased MS disease activity and indicates the need to optimise disease-modifying therapies to slow progression and preserve brain functioning. However, it is difficult to detect on clinical interview alone, and patient self-report is unreliable.

Objective: General practitioners (GP) can have a key role in the screening and initial management of cognitive impairment, but they need the right tools to do so. This aim of this article is to describe the best cognitive screening tools to use in MS and some psychological screening tools that can provide useful additional clinical information.

Discussion: The various ways in which information gleaned from applying these tools can guide GPs' care plans related to the effective management and treatment of cognitive impairment during three stages in the trajectory of cognitive change in MS are discussed.