Cognitive Dysfunction in Multiple Sclerosis: Educational Level as a Protective Factor

Abstract

Most people with MS experience cognitive deficits especially in attention, memory, information processing, and executive functions, negatively impacting on their quality of life. Cognitive variables of short-term memory, logical memory, and verbal fluency in 65 patients with multiple sclerosis (MS) were analysed in conjunction with sociodemographic variables such as sex, age, and educational level that might influence disease progression. We found that psychoeducational variables exerted a significant effect on the cognitive status of patients with MS. Thus, when considering sex, age, educational level, and type of MS (SPMS or RRMS), tests for between-subject effects revealed statistically significant differences in all three cognitive variables. In addition, we found that the type of MS and time since onset also generated significant cognitive differences. Our study shows that educational achievement or level is a protective factor against the disease, acting as a source of intellectual enrichment that promotes cognitive reserve in patients with MS. Further longitudinal studies assessing disease progression and prognosis in patients with MS would be useful in order to determine the specific importance of these variables in such patients and in strategies that could enhance their performance in neuropsychological assessment tasks.

Examining the Clinical Utility of Selected Memory-Based Embedded Performance Validity Tests in Neuropsychological Assessment of Patients with Multiple Sclerosis

“…Additionally, given the multiplicity of variables that may play a role in noncredible presentations (e.g., psychiatric symptomatology, presence of secondary gain), future research is strongly encouraged to parse out the relevant dimensions that may meaningfully contribute to and/or explain noncredible performance on cognitive tests. Finally, while differences in gender and years of education between credible and noncredible groups were not considered to be clinically meaningful in this study (as is consistent with prior research with similar aims) [45][46][47], future work may seek to consider the impact of baseline patient characteristics on neuropsychological test scores and, by extension, performance validity in pwMS, as some have suggested that level of education and/or disease subtype may differentially influence aspects of test performance in MS [63].…”

Role of Stress-Related Dopamine Transmission in Building and Maintaining a Protective Cognitive Reserve

“…Moreover, Alzheimer's disease (AD) patients with CR proxies can show more advanced AD-type neuropathology but comparable clinical severity of cognitive impairment than those without CR proxies [2,4]. Studies have reported similar findings in different neurodegenerative diseases such as multiple sclerosis [5], Parkinson's disease [6], and schizophrenia [7]. Therefore, there is an increasing interest in developing interventions capable of fostering CR in the treatment of cognitive decline.…”