Predictors of Assistive Technology Use for Cognitive Aids in MS.

Individuals with multiple sclerosis (MS) often experience limitations in participation in important activities. Assistive technology (AT) is one method to address these limitations and may take the form of mobility aids, devices for use in selfcare tasks, screen-enlargement software, vehicle modifications, and memory aids such as personal digital assistants. Although most research on AT use in MS has focused on mobility aids, it is critical to examine the use of AT as a cognitive prosthesis. Cognitive problems are common for individuals with MS, and a growing number of tools are available to help individuals compensate. We report on an evaluation of predictors of self-reported use of or need for assisted cognition from a community-dwelling sample of adults with MS. We found that of all types of AT assessed, cognitive aids and memory strategies were most frequently used or needed in our analysis of a 2005 self-administered mail survey (N = 110). Multiple logistic regression analysis was completed to determine which factors were significantly associated with memory aid use and need. Variables examined as predictors of current use of memory aids included education, employment status, difficulties thinking, use of mobility aids, pain, fatigue, and depression. Self-report of severity of problems with thinking was the only variable significantly associated with use of memory aids (Wald test [df = 1]: X^2= 5.66, P = .02). Need for memory aids, defined as needed but not available, was also examined, and regression analysis determined that self-report of high severity of problems thinking was the only significantly associated variable (Wald test [df = 1]: X^2 = 4.33, P = .04). Interestingly, this analysis suggested that individuals who perceived the highest decline in their cognitive function were more likely to currently use or want to use memory aids, regardless of other factors. Clinical and policy implication is also discussed.