Cognitive Impairment Screening in Multiple Sclerosis Using CoGeval: Clinical and Functional Predictors in a Mexican Cohort

Background/Objectives: Cognitive impairment is frequent in multiple sclerosis, yet routine screening is inconsistently implemented. We aimed to characterize cognitive impairment using CogEval in a Mexican cohort and to identify clinical and functional correlates. Methods: We conducted a cross-sectional study at UMAE No. 71 (Torreón, Mexico). Adults with MS (n = 81) underwent CogEval screening (classified as normal, mild, or severe). Disability, upper-limb dexterity (9-Hole Peg Test, mean of both hands), and gait speed (Timed 25-Foot Walk) were assessed. Bivariate tests and multivariable logistic regression examined associations with cognitive impairment. Results: Participants were 61.7% women; mean age was 35.7 ± 9.9 years. Median EDSS was 2.0 (IQR 1.0–4.0); 28.4% had EDSS ≥ 4. CogEval identified impairment in 49.4% (40/81), with 62.5% severe and 37.5% mild. In bivariate analyses, impairment was associated with higher EDSS (p < 0.001), slower 9-HPT (p < 0.001), and slower T25FW (p = 0.0058), but not with age, sex, or disease duration. In adjusted models, EDSS (OR 1.86, 95% CI 1.14–3.03; p = 0.012) and 9-HPT per second (OR 1.31, 95% CI 1.09–1.58; p = 0.005) independently predicted impairment, whereas T25FW and age were not significant. Discrimination was good (AUC = 0.863). Conclusions: About half of this Mexican MS cohort screened positive for cognitive impairment, particularly those with greater disability and reduced manual dexterity. CogEval appears feasible for routine screening and may help prioritize comprehensive neuropsychological assessment and rehabilitation.