Canadian Normative Data for Minimal Assessment of Cognitive Function in Multiple Sclerosis

Can J Neurol Sci. 2017 Sep;44(5):547-555. doi: 10.1017/cjn.2017.199. Epub 2017 Jul 7.


Objective: The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) is a consensus-based collection of neuropsychological tests that evaluate cognitive functioning in individuals with multiple sclerosis (MS). The tests are typically scored using each respective published test manual, leaving the examiner to make interpretations from norms derived from different American populations. Given demographic differences, this may lead to misinterpretation of findings in Canadians. Our goal was to establish both discrete and regression-based normative data for the MACFIMS based on a largely co-normed Canadian population to allow for improved psychometric interpretation.

Methods: MACFIMS data sets were aggregated from across three different Canadian cities (Ottawa, Toronto, and London), yielding a total of 330 healthy control participants from four different studies evaluating cognition in individuals with MS. Given the variety of contributing studies, there was variability in terms of the number of participants completing each measure.

Results: Both age-based discrete normative data and demographically adjusted (sex, age, and education) regression-based formulae were established. The demographic variables varied in their contribution to each MACFIMS test in the regression models, predicting 0 to 18% of the variance.

Conclusions: Provision of these regression-based formulae will allow for more accurate interpretation of Canadian-derived MACFIMS scores by allowing clinicians to correct for all relevant demographic variables simultaneously, leading to improved clinical decision making for individuals with multiple sclerosis.

Keywords: Canada; Multiple sclerosis; cognition; neuropsychological tests; psychometrics.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Canada
  • Cognition / physiology*
  • Cognition Disorders / physiopathology*
  • Consensus
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / psychology*
  • Neuropsychological Tests*
  • Psychometrics / methods
  • Reproducibility of Results
  • Young Adult