Mild Cognitive Impairment, AD in Multiple Sclerosis: What’s the Prevalence?

Incidence rates of mild cognitive impairment (MCI) and Alzheimer disease (AD) is low in newly diagnosed patients with multiple sclerosis (MS), according to study results presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2025, held in West Palm Beach, Florida from February 27 to March 1.

MCI and AD are chronic, progressive neurologic conditions that affect patients with MS, but real-world incidence data are limited. To assess the incidence of MCI and AD in this population, researchers conducted a retrospective study using data from the Komodo Health Claims Database from January 2017 through May 2023.

Adults aged 18 years and older who were recently diagnosed with MS and who had at least 12 months of follow-up data were included. Individuals with MS who had any use of disease-modifying therapies (DMTs) prior to the index diagnosis date were excluded. The researchers collected data on demographic and clinical characteristics and stratified patients by race.

A total of 193,885 patients with MS were enrolled (Asian, n=3128; Black, n=24,282; Hispanic, n=17,560; White, n=108,141). Overall, the mean time to follow-up from MS diagnosis was 3.6 years. A total of 8748 patients (4.5%) were diagnosed with MCI, and 2569 patients (1.3%) had a diagnosis of AD. Of those diagnosed with MCI, 4.7% progressed to AD.

At the time of MCI diagnosis, the mean age of Asian, Black, and Hispanic patients with MS were 52.2 years, 52.6 years, and 52.2 years, respectively, compared with 56.4 years in White patients (P <.001). Charlson Comorbidity Index (CCI) scores among Asian, Black, and Hispanic patients with MS were 1.39, 1.35, and 1.54, respectively, vs 0.98 in White patients (P <.001 for Hispanic and Black).

For AD, among Asian, Black, and Hispanic patients with MS, the mean age was 66.5 years, 66.0 years, and 68.4 years, respectively, vs 69.5 years in White patients (P <.001 for Black vs White race). For Asian, Black, and Hispanic patients with MS, CCI scores at time of AD diagnoses were 3.53, 2.32, and 2.90, respectively, compared with 1.70 for White patients (P <.001).

“Asian/Black/Hispanic patients were younger with higher CCI than White [persons with multiple sclerosis] at MCI diagnosis. Black [persons with multiple sclerosis] were younger than White at AD diagnosis and Asian/Black/Hispanic had higher CCI than White [persons with multiple sclerosis] at AD diagnosis,” the researchers concluded.

Disclosure: This research was supported by Biogen. Please see the original reference for a full list of disclosures.