Timed instrumental activities of daily living in multiple sclerosis: The test of everyday cognitive ability (TECA).

OBJECTIVE: Cognitive impairment is a common symptom of multiple sclerosis (MS) that can lead to declines in daily functioning. Timed instrumental activities of daily living (TIADLs) have been useful to bridge between cognitive testing and real-world functioning in disorders such as Alzheimer's disease and other dementias. However, these have not been standardized for general use, and the tasks that are typically employed have not been sensitive to the detection of milder forms of cognitive deficits. We developed a test of ten TIADLs tasks to measure a broader range of functioning, entitled the "Test of Everyday Cognitive Ability" or TECA, and tested its utility in a diverse sample of participants with MS. METHOD: TECA performance was characterized in n = 177 participants with MS and compared to healthy controls (n = 49). A subset from each group received repeated administration. In addition, all participants completed a standard battery of neuropsychological measures. RESULTS: TECA performances were significantly different between MS and control participants. Further, MS participants with cognitive impairment performed significantly slower relative to those MS participants without impairment. CONCLUSIONS: The TECA is a TIADLs assessment appropriate for use in those with MS as it includes a broad range of task difficulties, requires minimum motor involvement, and is sensitive to MS-related cognitive impairment. The TECA is a brief and repeatable test of TIADLs and its ease of administration makes it suitable for both clinical practice and research settings.

Money Management Activities in Persons With Multiple Sclerosis.

OBJECTIVES: To examine whether participants with multiple sclerosis (MS) have more problems in managing finances compared with persons without MS, and to examine the variables that may contribute to these problems. DESIGN: A cross-sectional study. SETTING: Nonprofit rehabilitation research institution and the community. PARTICIPANTS: Participants (N=53) comprised adults with MS (n=30) and persons without MS (n=23) who were recruited from a nonprofit rehabilitation research institution and from the community. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants were administered a battery of neuropsychological tests, a money management survey, and a functional test to assess money management skills. RESULTS: Individuals with MS reported and demonstrated more problems managing money than persons without MS. Impaired cognitive functioning was significantly correlated with difficulties in money management. Self-report of functional status (Functional Behavior Profile) was significantly correlated with self-reported money management skills. CONCLUSIONS: To our knowledge, this is the first study to examine money management in MS. Money management is an important activity of daily living that presents problems for individuals with MS. Managing one's own money requires adequate processing speed abilities as well as executive-attentional abilities. Additional studies are needed to explore this area and understand the nature of the problem.