International evaluation of current practices in MND cognitive assessment
February 2022: An international analysis of cognitive assessment in MND suggests that it has a positive impact on people with MND, their caregivers and healthcare professionals' practice.
It is now widely accepted that up to 50% of people with MND experience changes in cognition (defined as thinking, learning and memory) and/or behaviour.
Changes in cognition and behaviour may manifest as problems in communication, decision-making and interactions with family and caregivers. Moreover, they have been shown to affect wellbeing in people living with MND, and increase the burden on caregivers. Clinicians therefore recommend that people with MND are offered a timely cognitive assessment. Care management guidelines advise to explore, assess, manage and review any cognitive changes. Assessment of cognitive changes is therefore regarded as fundamental in the provision of appropriate care for people with MND in the UK.
The Edinburgh Cognitive and Behavioural ALS Screen (ECAS), developed by Euan MacDonald Centre researchers Professor Sharon Abrahams, Dr Thomas Bak and Ms Judy Newton, is the most commonly used cognitive test in Scotland and has been widely implemented in MND clinics across the UK. It is a 20-minute assessment specifically designed for those with physical disabilities, which has been developed for use by all health professionals.
Professor Abrahams and her PhD student, Debbie Gray, have now undertaken an international survey to assess the extent to which cognitive assessment is used in MND clinics around the world, as well as when and how the assessment is being carried out.
The team received responses to a survey from 80 MND clinics around the world. The survey indicated that the ECAS was the most popular method for evaluating cognition and 72% agreed that people screened for cognitive change have better clinical care.
Themes to have emerged from the survey responses indicated that cognitive assessments help to identify and validate changes in cognition and behaviour, aid understanding of the impact of the disease and inform/direct clinical care. Overall cognitive assessments were viewed as having a positive impact on people with MND, their caregivers and on health professionals' clinical practice.
Related links
Read the scientific article: Gray D and Abrahams S, International evaluation of current practices in cognitive assessment for motor neurone disease. British Journal of Neuroscience Nursing, Vol. 18, No. 1. doi.org/10.12968/bjnn.2022.18.1.38 (summary available; full text behind a paywall)
Professor Sharon Abrahams' profile
Edinburgh Cognitive ALS Screen