Interplay Between Cognitive and Bowel/Bladder Function in Multiple Sclerosis

Purpose: to evaluate the prevalence of bowel/bladder dysfunction in multiple sclerosis (MS) and the association with cognitive impairment. Methods: We prospectively enrolled 150 MS patients. Patients were administered the Symbol Digit Modality Test (SDMT), and filled the Neurogenic Bowel Dysfunction Score (NBDS) and the Actionable Bladder Symptom Screening Tool (ABSST). Association between bowel/bladder dysfunction and cognitive function was assessed through hierarchical regression models using SDMT and clinic-demographic features as independent variables and NBDS or ABSST score as dependent variables. Results: Prevalence for bowel/bladder deficit was 44.7%, with 26 patients (17.3%) suffering from bowel deficits and 60 patients (40%) from bladder deficits. Total NBDS and ABSST correlated with SDMT (coeff. = -0.10, p<0.001 and coeff. = -0.03, p=0.04, respectively) after correction for demographic features and physical disability. Conclusions: Bowel/bladder disorders are common in MS and are associated with both physical and cognitive disability burden. As SDMT is embedded into routine clinical assessment, a lower score may warrant investigating bowel/bladder dysfunction due their strong interplay.