The assessment of sustained attention in Multiple Sclerosis: comparison of psychometric measures and correlates with everyday cognitive function

Multiple Sclerosis (MS) is the most common disabling neurological disease affecting young and middle-aged adults (Arnett, 2003). It is only in recent years however that the influence of cognitive impairment as a causal factor in disability in MS has been recognised. Despite clinical recognition and anecdotal reports of attentional difficulties the status of attention in MS arguably remains unclear with inconsistent findings in the research literature. The impact of sustained attention was discerned from other theoretical types of attention and the assessment of it provided the focus for study.The Sustained Attention to Response Task (SART) was developed for using with the traumatic brain-injured population and is purported to be a sensitive and valid measure of sustained attention. The main aim of the study was to investigate whether performance on it could be replicated with an MS population. The principal hypothesis stated that there would be a significant difference between a sample of MS patients and a healthy control group across attentional measures. The Lottery and Elevator Counting subtests from the Test of Everyday Attention, the Symbol Digits Modalities Test formed the main assessment tools used. Another aim of the study was to determine how well performance on these tests predicted everyday cognitive functioning, as measured by the self and informant-reported Cognitive Failures Questionnaire.The results demonstrated that sustained attention deficits were indeed a part of the cognitive profile in this sample of MS patients. In its current format performance on the SART was not found to be a valid measure for using with the MS population. The other three attentional tests were however able to discern a significant difference in performance between the two groups. Performance on these test were also found to significantly correlated with and hence be predictive of everyday cognitive functioning as measured by the informant-reported Cognitive Failures Questionnaire