{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:40:48Z","timestamp":1792435248324,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100019746","name":"Sunnybrook Foundation","doi-asserted-by":"publisher","award":["Multiple Sclerosis Neuropsychiatry Fellowship"],"award-info":[{"award-number":["Multiple Sclerosis Neuropsychiatry Fellowship"]}],"id":[{"id":"10.13039\/100019746","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"abstract":"<jats:p>\n                    In 334 people with multiple sclerosis, a backward stepwise regression analysis was conducted to identify clinical characteristics that predict who declines neurocognitive testing (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05), from demographics, disease-related variables, psychiatric diagnoses, and self-reported cognitive concerns. The mean age was 44.1\u2009years (standard deviation\u2009=\u200911.4), the median Expanded Disability Status Scale was 2.5 (1.5\u20134.0), 79.8% had relapsing-remitting MS, and 14.7% declined testing. Independent correlates of declining neurocognitive testing included progressive MS (odds ratio\u2009=\u20092.1, 95% confidence interval = [1.0, 4.4],\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.046), anxiety-related disorders (odds ratio\u2009=\u20092.5, 95% confidence interval = [1.3, 4.9],\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.007), and the absence of self-reported cognitive concerns (odds ratio\u2009=\u20090.3, 95% confidence interval = [0.2, 0.7],\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.004). People with multiple sclerosis with these clinical characteristics are more likely to decline neurocognitive testing.\n                  <\/jats:p>","DOI":"10.1177\/13524585261491122","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:54:40Z","timestamp":1792230880000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Who declines neurocognitive testing? A cross-sectional study in people with multiple sclerosis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-3232","authenticated-orcid":false,"given":"David E.","family":"Freedman","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Department of Psychiatry and The BARLO MS Centre, St. Michael\u2019s Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, St. Michael\u2019s Hospital, Toronto, ON, Canada"},{"name":"Division of Neurology, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0132-0909","authenticated-orcid":false,"given":"Anthony","family":"Feinstein","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"},{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Department of Psychiatry and The BARLO MS Centre, St. Michael\u2019s Hospital, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","unstructured":"Benedict RHB Amato MP DeLuca J et al. 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Mult Scler J Exp Transl Clin 2024; 10(4): 20552173241307619. https:\/\/doi.org\/10.1177\/20552173241307619","DOI":"10.1177\/20552173241307619"},{"key":"e_1_3_4_11_2","doi-asserted-by":"crossref","unstructured":"Waskowiak PT De Jong BA Uitdehaag BMJ et al. Cognitive awareness in people with multiple sclerosis before and after neuropsychological assessment. J Neurol 2025; 272(11): 748. https:\/\/doi.org\/10.1007\/s00415-025-13486-2","DOI":"10.1007\/s00415-025-13486-2"},{"key":"e_1_3_4_12_2","doi-asserted-by":"crossref","unstructured":"Freedman DE Benedict RHB Oh J et al. The non-linear relationship between self-reported cognitive concerns and performance-based cognitive dysfunction in people with multiple sclerosis: a cross-sectional study. J Neurol 2026; 273(3): 190. https:\/\/doi.org\/10.1007\/s00415-026-13743-y","DOI":"10.1007\/s00415-026-13743-y"},{"key":"e_1_3_4_13_2","doi-asserted-by":"crossref","unstructured":"Morriss J. 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