Assessing cognition in MS clinical trials: The Cognitive Assessment Interview (CAI) (P3.233)

OBJECTIVE: To evaluate the semi-structured Cognitive Assessment Interview (CAI) in multiple sclerosis (MS). BACKGROUND: Cognitive impairment has not yet been reliably assessed by interview. Our goal was to determine if the CAI, a sensitive interview-based measure of change in cognitive functioning developed for use in schizophrenia clinical trials, would be applicable in MS. DESIGN/METHODS: MS participants completed a baseline neuropsychological assessment and CAI that included an informant when possible. The CAI rates degree of impairment across 10 cognitive domains with scores including a Clinical Global Impression (CGI) and Global Assessment of Function (GAF). Neuropsychological measures included the Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), Selective Reminding Test (SRT), the Brief Visuospatial Memory Test-Revised (BVMT-R) and the Timed Instrumental Activities of Daily Living (TIADLs). RESULTS: 66 participants completed the CAI, mean age was 48 years (range 19 to 69); 73[percnt] female; most (84[percnt]) had relapsing remitting type, with a median EDSS score of 3.5 (range of 1.0 to 8.0). MS participants’ reports were generally consistent with the informants (r values >0.30, with the lowest agreement for social cognition). Working memory and speed processing were domains most commonly impaired. Mean CGI rating was 3.11 ± 0.90 (range 1 to 5), indicating mild impairment overall, and mean GAF was 67.57 ± 10.25 (range 45 to 90), indicating some difficulty in functioning. The composite GAF was more strongly related to cognitive performance than the CGI. The GAF was modestly correlated with the PASAT (r=0.28, p=.02), unrelated to the SDMT and learning measures (r values <0.12), and modestly correlated with errors in completing TIADLs (r= -0.26, p=0.05). CONCLUSIONS: The CAI measures the real-world experience of MS-related cognitive deficits and is useful in MS clinical trials. Study Supported by: The National MS Society and The Lourie Foundation, Inc. Disclosure: Dr. Marzillano has nothing to disclose. Dr. Speed has nothing to disclose. Dr. Cersosimo has nothing to disclose. Dr. Sherman has nothing to disclose. Dr. Shaw has nothing to disclose. Dr. Fang has nothing to disclose. Dr. Haider has nothing to disclose. Dr. Melville has nothing to disclose. Dr. Krupp has received personal compensation for activities with Teva Neurosciences, Biogen Idec, EDM Serono, and Bayer Healthcare as a consultant and/or speakers bureau participant. Dr. Charvet has received personal compensation for activities with Biogen Idec as a consultant.