Managing cognitive impairment and its impact in multiple sclerosis: An Australian multidisciplinary perspective

•In Australia, there is a lack of guidance on MS cognitive screening and monitoring.•Cognitive impairment can be a predictor and marker of further progression.•There are several cognitive tests/batteries recommended for patients with MS.•This Australian expert working group suggests routine cognitive assessment.•Changes in cognition should trigger a thorough investigation of the cause. Cognitive impairment in multiple sclerosis (MS) affects approximately 40–70% of patients and can have varying degrees of severity. Even mild cognitive impairment can impact on quality of life and productivity. Despite this, patients are not routinely screened or monitored for cognitive impairment in Australia due to a range of issues, with time and space being the main limiting factors. This Australian multidisciplinary perspective provides recommendations on cognition management in Australia. It gives a broad overview of cognition in MS, advice on the screening and monitoring tools available to clinicians, and strategies that can be implemented in clinics to help monitor for cognitive impairment in patients with MS. We suggest a routine baseline assessment and multidomain cognitive battery in regular intervals; a change should trigger a thorough investigation of the cause.