The protective effects of high-education levels on cognition in different stages of multiple sclerosis

Rimkus, Carolina de Medeiros; Avolio, Isabella Maria Bello; Miotto, Eliane Correa; Pereira, Samira Luisa Apóstolos; Mendes, Maria Fernanda; Callegaro, Dagoberto; Leite, Cláudia da Costa

doi:10.1016/j.msard.2018.03.001

Cited by 32 publications

(29 citation statements)

References 42 publications

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“…One explanation for this discrepancy may be that the current sample is unique in terms of a homogeneous sample in a very early disease stage with a median disease duration of only 0.33 years [ 18 ]. Compensatory mechanisms such as cognitive reserve may attenuate direct measurability of CI specifically in young patients with low overall disease burden and high formal education resulting in lower frequencies [ 17 ]. Hence, patients with larger cognitive reserve capacity may be able to compensate for brain pathology despite suffering from clinically relevant CI [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…and (iv) employed MRI techniques and length of follow-up periods. These methodological issues currently impede an integration and extrapolation of results onto individual cases with newly diagnosed MS [ 6 , 8 , 10 , 11 , 14 – 17 ]. In turn, this gap in key-knowledge hinders incorporation of cognitive monitoring into standard clinical care which in turn hampers the development and evaluation of specific programs for the prevention and rehabilitation of CI in MS [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)

et al. 2018

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Background Cognitive impairment (CI) affects approximately one-third of the patients with early multiple sclerosis (MS) and clinically isolated syndrome (CIS). Little is known about factors predicting CI and progression after initial diagnosis. Methods Neuropsychological screening data from baseline and 1-year follow-up of a prospective multicenter cohort study (NationMS) involving 1123 patients with newly diagnosed MS or CIS were analyzed. Employing linear multilevel models, we investigated whether demographic, clinical and conventional MRI markers at baseline were predictive for CI and longitudinal cognitive changes. Results At baseline, 22% of patients had CI (impairment in ≥2 cognitive domains) with highest frequencies and severity in processing speed and executive functions. Demographics (fewer years of academic education, higher age, male sex), clinical (EDSS, depressive symptoms) but no conventional MRI characteristics were linked to baseline CI. At follow-up, only 14% of patients showed CI suggesting effects of retesting. Neither baseline characteristics nor initiation of treatment between baseline and follow-up was able to predict cognitive changes within the follow-up period of 1 year. Conclusions Identification of risk factors for short-term cognitive change in newly diagnosed MS or CIS is insufficient using only demographic, clinical and conventional MRI data. Change-sensitive, re-test reliable cognitive tests and more sophisticated predictors need to be employed in future clinical trials and cohort studies of early-stage MS to improve prediction. Electronic supplementary material The online version of this article (10.1007/s00415-018-9142-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)

et al. 2018

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“…This finding agreeable with [48,45] who described that level of education, knowledge and beliefs, are the most strongest predictor in self-management behavior in predicting quality of life for MS patients. [49] clarify that low education levels, might indirect contribute to unhealthy patterns such as; physical inactivity, obesity, smoking, poor treatment adherence and other associated co-morbid diseases. [50,51] confirmed that patient information and knowledge about MS is essential part of informed decision making in treatment and patients with lower education level consistently showed more impaired quality of Life domains.…”

Section: Discussionmentioning

confidence: 99%

Fatigue and Self-management among Multiple Sclerosis Patients

Shawli¹,

Abdulmutalib²,

Nagshabandi³

2019

AJNR

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Fatigue is considered as the most revealed symptoms in multiple sclerosis patients, reported by 88% of patients and has significant impact on all stages of life such as altering in daily living activity or psychosocial/mental functions. The pathogenesis of fatigue remain poorly understood and how its impact on self-management. The aim of study was to assess fatigue and self management among multiple sclerosis patients. A quantitative descriptive correlational design was used in this study. The study was conducted at both King Abdulaziz University Hospital and King Fahad Armed Forces Hospitals in Jeddah City from January till March 2018, data collected from outpatients' clinic and Inpatients' medical-wards. A convenience sample of 50 Multiple Sclerosis patients. Data was collected through the main one tool, it consists of three parts; Part I, Socio-demographic and clinical data constructed by the researchers. Part П, Modified Fatigue Impact scale; to assess the Impact of fatigue on physical, cognitive, and psychosocial functioning in patient with Multiple Sclerosis.. Part ПІ, Multiple Sclerosis Self Management Scale Revised; to provide a multidimensional and psychometrically assessment of self-management knowledge and behavior among Multiple Sclerosis patients. The study results showed there was a statistically significant negative correlations between fatigue subscales and overall self-management among Multiple Sclerosis patients with p-value (.019). Also, there was a statistically significant negative correlations between self-management factor scales and overall fatigue among Multiple Sclerosis patients with p-value (.019). It was concluded that there was a negative correlations between overall fatigue and overall self-management among Multiple Sclerosis patients, whenever fatigue severity increases, self-management decreases. It was a recommendation to encourage governmental policy and other decision makers in the Saudi community to develop periodically structure health education training program regarding self-management in MS and provide appropriate environments or facilities to conduct such programs, where nurses play a key role through health education and cooperate with other health care system.

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“…Better schooling, for example, is frequently associated with lower dementia risk and higher reserve against cognitive deterioration. It has also repeatedly been shown that better school education offsets the detrimental effects of brain damage (eg, due to neurodegenerative changes) 22 ; this effect is not limited to AD, but has also been shown for other dementias such as frontotemporal dementia (FTD) 23,24 and dementia with Lewy bodies, 25 and other neurological and psychiatric disorders, including multiple sclerosis 26 and schizophrenia. 27 The concept of reserve was proposed to account for the repeated observation that individuals with certain characteristics have higher resilience against ageor disease-related brain changes.…”

Section: Risk and Protective Factorsmentioning

confidence: 96%

Dementia prevention and reserve against neurodegenerative disease

Perneczky

2019

Dialogues in Clinical Neuroscience

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Similar to other complex disorders, the etiology of Alzheimer disease is multifactorial and characterized by an interplay of biological and environmental risk and protective factors. Potentially modifiable risk factors have emerged from epidemiological research and strategies to prevent neurodegeneration and dementia are currently being tested, including multimodal interventions aiming to reduce several risk factors at once. The concept of reserve was developed based on the observation that certain individual characteristics, such as life experiences, lifestyles, and neurobiological parameters, are associated with a higher resilience against neurodegeneration and its symptoms. Coordinated research is required to maximize the use of available human and financial resources to better understand the underlying neurobiological mechanisms of reserve and to translate research findings into effective public health interventions.

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The protective effects of high-education levels on cognition in different stages of multiple sclerosis

Cited by 32 publications

References 42 publications

Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)

Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)

Fatigue and Self-management among Multiple Sclerosis Patients

Dementia prevention and reserve against neurodegenerative disease

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