Screenings if you have multiple sclerosis

The yearly comprehensive review

NICE says to ensure all people with MS have a comprehensive review of all aspects of their care at least once a year, carried out by healthcare professionals with expertise in MS and its complications, and to explain to people with MS that they should ask for a review if it has not taken place. (NICE NG220) NICE says the review is tailored to the person and assesses, among other things: (NICE NG220)

mobility and balance, including falls
bladder, bowel and sexual function
speech and swallowing
vision
cognitive symptoms
depression and anxiety
sleep and respiratory function
general health, including weight, smoking, alcohol and recreational drugs, and access to routine health screening and contraception
care of other chronic conditions

NICE says to refer any issues found during the review to members of the MS multidisciplinary team and other appropriate teams. (NICE NG220) See questions to ask your doctor.

Memory and thinking

NICE says to talk to people with MS about the possibility that the condition might lead to cognitive problems, to be aware that these can include memory problems that the person may not immediately recognise or link with MS, and to assess cognition as part of the comprehensive review. It adds that anxiety, depression, difficulty sleeping, fatigue and medication can affect cognition. (NICE NG220) The National MS Society recommends, for adults and children 8 years or older with MS: (National MS Society, 2018)

an early baseline screen with the Symbol Digit Modalities Test (SDMT) or a similarly validated test, when the person is clinically stable
a re-check every year with the same test, or more often as needed
a fuller assessment for adults who screen positive or show a clear drop from a previous screen, and for children whose school functioning changes for no clear reason

See memory screening (Mini-Cog and MoCA).

Depression and anxiety

NICE lists depression and anxiety among the areas the comprehensive review assesses. (NICE NG220) MedlinePlus lists depression among the possible complications of MS. (MedlinePlus) The National MS Society recommends depression screening at least yearly, with the Beck Depression Inventory Fast Screen or the Hospital Anxiety and Depression Scale for adults, or an age-appropriate tool for children. (National MS Society, 2018) The American Academy of Neurology (AAN) says clinicians may consider the Beck Depression Inventory and a 2-question tool to screen for depression in MS (Level C, possibly effective). (AAN, 2014) See depression screening: what to expect, anxiety screening (GAD-7) and mental health screenings by age.

Bone health

NICE says to ensure people with MS have their bone health regularly assessed and reviewed in line with NICE's guideline on osteoporosis. (NICE NG220) MedlinePlus lists osteoporosis, or thinning of the bones, among the possible complications of MS. (MedlinePlus) Neither source sets a bone density scan schedule for people with MS. See bone density test: how often and DEXA scan: what to expect.

Bladder, vision and falls

The NHS lists needing to pee more often or not being able to control when you pee, and problems with the eyes or vision, among the most common symptoms of MS. (NHS) MedlinePlus lists urinary tract infections among the possible complications. (MedlinePlus) NICE includes bladder function, vision, and mobility and balance including falls in the comprehensive review. (NICE NG220) See fall risk screening, eye exams by age and urinalysis results.

Planning a family

NICE says to ask people with MS soon after diagnosis and at regular intervals whether they plan to start or extend their family, and to explain that they should talk with their healthcare professionals if they plan to start or extend their family or become pregnant. (NICE NG220) See preconception checkup screenings.

Usual screening on schedule

MS does not change the general schedules for cancer, heart and other screening in the sources on this page. NICE lists access to routine health screening and care of other chronic conditions in the yearly review. (NICE NG220) In a large US cohort of privately insured people, those with MS had about double the rate of potentially preventable hospital stays of people without MS, and among people with MS, cholesterol screening and annual wellness visits were linked with lower odds of such a stay. (Khan, 2022) See cancer screenings by age, cholesterol test by age and screenings by age and gender.

When to contact a provider

MedlinePlus, multiple sclerosis, when to contact a medical professional: (MedlinePlus)

Contact your provider if: You develop any symptoms of MS; Your symptoms get worse, even with treatment; The condition worsens to the point when home care is no longer possible.

The NHS says to call 999 or go to A&E if you have sudden weakness or numbness in 1 arm, loss or blurring of vision, or problems with balance and co-ordination, because these could be signs of a stroke. (NHS)

Where they differ:

Memory and thinking checks. The National MS Society names a test (the SDMT or a similar validated test), a baseline screen and a yearly re-check, and includes children from age 8; (National MS Society, 2018) NICE NG220 covers adults and asks for cognition to be assessed as part of the yearly review, tailored to the person, without naming one test. (NICE NG220)
Depression screening. The National MS Society recommends screening at least yearly with named tools; (National MS Society, 2018) the AAN found the evidence for screening tools in MS only possibly effective (Level C) and sets no interval. (AAN, 2014)

Your doctor decides what your result means for you.

Questions people ask

How often should someone with MS have a full review?

NICE says all people with MS should have a comprehensive review of all aspects of their care at least once a year, carried out by healthcare professionals with expertise in MS, and that people should ask for one if it has not taken place. (NICE NG220)

Should people with MS have memory and thinking checks?

NICE says to assess cognition as part of the yearly comprehensive review. The National MS Society recommends a baseline cognitive screen, such as the Symbol Digit Modalities Test, for adults and children 8 years or older with MS, and a re-check with the same test every year or more often as needed. (NICE NG220) (National MS Society, 2018)

Should people with MS be screened for depression?

NICE lists depression and anxiety among the areas the yearly review assesses. The National MS Society recommends depression screening at least yearly, and the American Academy of Neurology says clinicians may consider the Beck Depression Inventory or a 2-question tool to screen for depression in MS. (NICE NG220) (National MS Society, 2018) (AAN, 2014)

Does MS change the usual cancer and heart screening schedule?

The sources on this page do not set a different schedule. NICE lists access to routine health screening among the general health topics in the yearly review, and a large US study found that people with MS who had cholesterol screening and annual wellness visits had lower odds of a potentially preventable hospital stay. (NICE NG220) (Khan, 2022)