Profile of a Newly Diagnosed Person with Multiple Sclerosis

Background: The Tanner Center for Multiple Sclerosis in Birmingham, AL is a comprehensive care center that began offering a weekly multidisciplinary newly diagnosed MS clinic in August 2011. The client is evaluated by a physical, occupational therapist, and licensed counselor. Through this clinic, the healthcare professionals have been able to gather baseline data for this cohort to better understand and outline deficits detected at early diagnosis.

Objectives: The Tanner Center for MS is providing baseline data for each newly diagnosed individual to determine focal areas for therapy, establishing compensatory techniques to ensure vocational independence, and strategies for adjustment to a new diagnosis. Gathering this initial data has allowed the center to accurately profile a newly diagnosed individual in Alabama, and to have a baseline established to distinguish relapses from pseudorelapses.

Methods: The occupational therapist in addition to routine evaluation incorporates the Timed Up and Go (TUG) and the Fatigue Severity Scale (FSS). The physical therapist incorporates the Multiple Sclerosis Functional Composite (MSFC). In addition to assessing adjustment to diagnosis, the licensed counselor administers a computerized neurocognitive battery (CNS Vital Signs) to screen for possible deficits across eight cognitive domains.

Results: Basic demographic information: 36 clients seen August 2011- August 2012. Age range: 16-52, Mean 36. Education: 14 years. Sex: Female 78%, Male 22%. Race: Caucasian 38%, African American 62%. Marital Status: Single 32%, Married 65%, Divorced 3%, Widowed 0%. Employment: Employed 81%, Unemployed 3%, Disabled 3%, Student 3%, Homemaker 10%. MSFC: PASAT 38.8% scored above the mean, NHPT 75% scored below the mean, T25FW 97% scored below the mean. TUG:33% scored above the mean. FSS: 68.3% scored above the mean. Cognition: 51% scored WNL on 8/8 domains, 46% scored 1.5 SD below mean in 1 domain, 16% scored 1.5 SD below the mean in 3- 4, and 15% scored 1.5 SD below the mean in 6-8 domains.Of note, of those with deficits in 6-8 domains at the time they were screened, 4/5 were disabled from work within 3-6 months.

Conclusions: The profile of a person newly diagnosed with MS is a married, African American female in her mid thirties employed with some degree of higher education. According to the MSFC results, almost all clients have a high level of lower and upper extremity function, however, their speed and flexibility of information processing is significantly lower. The findings from the neurocognitive screening indicated that speeded processing was deficient, however, the majority of individuals were judged to be without cognitive impairment that would interfere with work. A small percentage with deficits in multiple cognitive domains at the time of diagnosis, were more likely to be disabled from work within 6 to 12 months. This cohort has a high probability of fatigue, but a low risk of fall according to the TUG and FSS scores.