# Investigating the Associated Factors of Mood Disorders and Fatigue in Multiple Sclerosis Patients With Cognitive Impairment: A Cross‐Sectional Study

## TL;DR

This study explores how mood disorders and fatigue are linked to cognitive impairment in multiple sclerosis patients, focusing on factors like age, disease duration, and disability levels.

## Contribution

The study identifies specific cognitive domains and demographic factors associated with mood disorders and fatigue in MS patients with cognitive impairment in Iran.

## Key findings

- Information processing speed and working memory are most affected in MS patients with cognitive impairment.
- Mood disorders are more common in older patients and those with higher disability levels.
- Women with MS experience higher fatigue intensity compared to men.

## Abstract

This study aimed to investigate the factors associated with mood disorders and fatigue in multiple sclerosis patients with cognitive impairment.

This cross‐sectional study included 70 out of 155 MS patients exhibiting cognitive impairment (CI) from a referral clinic in Kerman, Iran, between 2023 and 2024. The Persian‐adapted Brief International Cognitive Assessment for MS (BICAMS) tests, which include the California Verbal Learning Test (CVLT‐II) to assess auditory or verbal episodic memory, the Symbol Digit Modalities Test (SDMT) to assess visual processing speed and working memory have been used. Independent t‐test compared CI between patients with and without CI, and linear regression analyzed factors associated with mood disorder and fatigue.

Out of 70 patients, 61 (87.1%) were women. The most frequently reported symptoms were fatigue and mood disorders. The mean of BICAMS domains in patients with CI was significantly lower than in non‐CI patients (p < 0.05). And the Symbol Digit Modality Test (SDMT) was the most frequently impaired domain (63.3%). A regression analysis showed a positive association of age (B = 0.346, p < 0.001), MS duration (B = 0.245, p < 0.001), and Expanded Disability Status Scale (EDSS) (B = 0.637, p < 0.001) with mood disorders. Furthermore, woman participants exhibited greater fatigue intensity than men (B = 0.260, p = 0.005). Additionally, as EDSS increased, fatigue intensity increased (B = 0.259, p < 0.001).

Information processing speed and working memory were the most affected cognitive domains in MS patients. Furthermore, mood disorders were more prevalent in older patients and those with higher EDSS, while fatigue was more pronounced in women and those with higher EDSS. Therefore, it is of higher importance to address the issue of CI and its association with fatigue and depression, particularly in the Iranian people.