Abstract
The present study aims to investigate the relationships between indices of cognitive reserve and cognitive impairment in patients with multiple sclerosis (pwMS). In this descriptive-correlational study, the statistical population included all pwMS who visited the MS Clinic of Isfahan, (Iran) in 2022. The convenience sampling method was employed to select 106 patients. The research instruments included the Cognitive Reserve Index Questionnaire (CRIq) and Multiple Sclerosis Neuropsychological Questionnaire (MSNQ). Multiple regression and analysis of variance (ANOVA) were adopted for data analysis in SPSS. Regression analysis revealed that CRI-education and CRI-working activity had significant relationships with cognitive impairment (p < 0.01). The coefficient of determination indicated that cognitive reserve explained 16% of changes in cognitive impairment in pwMS. Considered an index of cognitive reserve, leisure time (CRI-leisure time) had no significant relationships with cognitive impairment in pwMS. Although there were no confirmed relationships between gender and cognitive impairment in pwMS, there was a significant difference in the degree of cognitive impairment based on marital status (p < 0.01).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Alfredsson, L., & Olsson, T. (2019). Lifestyle and environmental factors in multiple sclerosis. Cold Spring Harb Perspect Med, 9(4). https://doi.org/10.1101/cshperspect.a028944.
Amato, M. P., Prestipino, E., Bellinvia, A., Niccolai, C., Razzolini, L., Pastò, L., Fratangelo, R., Tudisco, L., Fonderico, M., Mattiolo, P. L., Goretti, B., Zimatore, G. B., Losignore, N. A., Portaccio, E., & Lolli, F. (2019). Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors. PLoS One, 14(10), e0222929. https://doi.org/10.1371/journal.pone.0222929.
Benedict, R. H., Munschauer, F., Linn, R., Miller, C., Murphy, E., Foley, F., & Jacobs, L. (2003). Screening for multiple sclerosis cognitive impairment using a self-administered 15-item questionnaire. Multiple Sclerosis (Houndmills, Basingstoke, England), 9(1), 95–101. https://doi.org/10.1191/1352458503ms861oa.
Benedict, R. H. B., Amato, M. P., DeLuca, J., & Geurts, J. J. G. (2020). Cognitive impairment in multiple sclerosis: Clinical management, MRI, and therapeutic avenues. Lancet Neurology, 19(10), 860–871. https://doi.org/10.1016/s1474-4422(20)30277-5.
Buscarinu, M. C., Reniè, R., Morena, E., Romano, C., Bellucci, G., Marrone, A., Bigi, R., Salvetti, M., & Ristori, G. (2022). Late-onset MS: Disease Course and Safety-Efficacy of DMTS. Frontiers in Neurology, 13, 829331. https://doi.org/10.3389/fneur.2022.829331.
Caruso, G., Godos, J., Privitera, A., Lanza, G., Castellano, S., Chillemi, A., Bruni, O., Ferri, R., Caraci, F., & Grosso, G. (2022). Phenolic Acids and Prevention of Cognitive Decline: Polyphenols with a Neuroprotective Role in Cognitive Disorders and Alzheimer’s Disease. Nutrients, 14(4). https://doi.org/10.3390/nu14040819.
Chen, Y. X., Liang, N., Li, X. L., Yang, S. H., Wang, Y. P., & Shi, N. N. (2021). Diagnosis and treatment for mild cognitive impairment: A systematic review of clinical practice guidelines and Consensus statements. Frontiers in Neurology, 12, 719849. https://doi.org/10.3389/fneur.2021.719849.
Corbo, I., Marselli, G., Di Ciero, V., & Casagrande, M. (2023). The Protective Role of Cognitive Reserve in mild cognitive impairment: A systematic review. Journal of Clinical Medicine, 12(5), 1759. https://doi.org/10.3390/jcm12051759.
Dahl, A. K., Löppönen, M., Isoaho, R., Berg, S., & Kivelä, S. L. (2008). Overweight and obesity in old age are not associated with greater dementia risk. Journal of the American Geriatrics Society, 56(12), 2261–2266. https://doi.org/10.1111/j.1532-5415.2008.01958.x.
Darwish, H., Farran, N., Assaad, S., & Chaaya, M. (2018). Cognitive Reserve Factors in a developing country: Education and Occupational Attainment Lower the risk of Dementia in a sample of Lebanese older adults. Frontiers in Aging Neuroscience, 10, 277. https://doi.org/10.3389/fnagi.2018.00277.
de Rooij, S. R. (2022). Are brain and Cognitive Reserve shaped by early life circumstances? Front Neurosci, 16, 825811. https://doi.org/10.3389/fnins.2022.825811.
DeLuca, G. C., Yates, R. L., Beale, H., & Morrow, S. A. (2015). Cognitive impairment in multiple sclerosis: Clinical, radiologic and pathologic insights. Brain Pathology, 25(1), 79–98. https://doi.org/10.1111/bpa.12220.
Devignes, Q., Viard, R., Betrouni, N., Carey, G., Kuchcinski, G., Defebvre, L., Leentjens, A. F. G., Lopes, R., & Dujardin, K. (2021). Posterior cortical cognitive deficits are Associated with structural brain alterations in mild cognitive impairment in Parkinson’s Disease [Original Research]. Frontiers in Aging Neuroscience, 13. https://doi.org/10.3389/fnagi.2021.668559. https://www.frontiersin.org/articles/.
Di Tella, M., Clerico, M., & Castelli, L. (2023). Associations between socioemotional alterations, quality of life, and social functioning in multiple sclerosis: A scoping review. Current Psychology, 42(13), 11143–11154. https://doi.org/10.1007/s12144-021-02387-y.
Elshebawy, H., Fahmy, E. M., Elfayoumy, N. M., Abdelalim, A. M., & Ismail, R. S. (2021). Clinical predictors to cognitive impairment in multiple sclerosis patients. The Egyptian Journal of Neurology Psychiatry and Neurosurgery, 57(1), 38. https://doi.org/10.1186/s41983-021-00292-6.
Eskandarieh, S., Heydarpour, P., Elhami, S. R., & Sahraian, M. A. (2017). Prevalence and incidence of multiple sclerosis in Tehran, Iran. Iran J Public Health, 46(5), 699–704.
Ghasemi, N., Razavi, S., & Nikzad, E. (2017). Multiple sclerosis: Pathogenesis, symptoms, diagnoses and Cell-based therapy. Cell J, 19(1), 1–10. https://doi.org/10.22074/cellj.2016.4867.
Giedraitiene, N., Drukteiniene, E., Kizlaitiene, R., Cimbalas, A., Asoklis, R., & Kaubrys, G. (2021). Cognitive decline in multiple sclerosis is related to the progression of Retinal Atrophy and Presence of Oligoclonal bands: A 5-Year Follow-Up study. Frontiers in Neurology, 12, 678735. https://doi.org/10.3389/fneur.2021.678735.
Gil-González, I., Martín-Rodríguez, A., Conrad, R., & Pérez-San-Gregorio, M. (2020). Quality of life in adults with multiple sclerosis: A systematic review. British Medical Journal Open, 10(11), e041249. https://doi.org/10.1136/bmjopen-2020-041249.
Grzegorski, T., & Losy, J. (2017). Cognitive impairment in multiple sclerosis - a review of current knowledge and recent research. Reviews in the Neurosciences, 28(8), 845–860. https://doi.org/10.1515/revneuro-2017-0011.
Halabchi, F., Alizadeh, Z., Sahraian, M. A., & Abolhasani, M. (2017). Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. Bmc Neurology, 17(1), 185. https://doi.org/10.1186/s12883-017-0960-9.
Hatami, J., Feizi khajeh, A., Rahiminezhad, A., Farahani, H., & Rezapour, T. (2020). Validation of Persian Version of Cognitive Reserve Index Questionnaire (CRIq). Journal of Applied Psychological Research, 11(1), 87–99. https://doi.org/10.22059/japr.2020.288425.643348.
Hosseini, Z., Homayuni, A., & Etemadifar, M. (2022). Barriers to quality of life in patients with multiple sclerosis: A qualitative study. BMC Neurology, 22(1), 174. https://doi.org/10.1186/s12883-022-02700-7.
Hou, J., Kim, N., Cai, T., Dahal, K., Weiner, H., Chitnis, T., Cai, T., & Xia, Z. (2021). Comparison of Dimethyl Fumarate vs Fingolimod and Rituximab vs Natalizumab for treatment of multiple sclerosis. JAMA Netw Open, 4(11), e2134627. https://doi.org/10.1001/jamanetworkopen.2021.34627.
Karalı, F. S., Maviş, İ., & Cinar, N. (2022). Comparison of language and narrative features of individuals among amnestic mild cognitive impairment and healthy adults. Current Psychology. https://doi.org/10.1007/s12144-022-03669-9.
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet, 396(10248), 413–446. https://doi.org/10.1016/s0140-6736(20)30367-6.
López-Higes, R., Rubio-Valdehita, S., Delgado-Losada, M. L., & López-Sanz, D. (2023). Influence of cognitive reserve on neuropsychological performance in subjective cognitive decline and mild cognitive impairment older adults. Current Psychology. https://doi.org/10.1007/s12144-023-04534-z.
Macías Islas, M., & Ciampi, E. (2019). Assessment and Impact of Cognitive Impairment in multiple sclerosis: An overview. Biomedicines, 7(1). https://doi.org/10.3390/biomedicines7010022.
Maurino, J., Martínez-Ginés, M. L., García-Domínguez, J. M., Solar, M. D., Carcelén-Gadea, M., Ares-Luque, A., Ballabriga, J., Navarro-Cantó, L., Medrano, N., Honan, C. A., & W-IMPACT Study Group. (2020). Workplace difficulties, health-related quality of life, and perception of stigma from the perspective of patients with multiple sclerosis. Multiple Sclerosis and Related Disorders, 41, 102046. https://doi.org/10.1016/j.msard.2020.102046.
McCollum, L., & Karlawish, J. (2020). Cognitive impairment evaluation and management. Medical Clinics of North America, 104(5), 807–825. https://doi.org/10.1016/j.mcna.2020.06.007.
Meca-Lallana, V., Gascón-Giménez, F., Ginestal-López, R. C., Higueras, Y., Téllez-Lara, N., Carreres-Polo, J., Eichau-Madueño, S., Romero-Imbroda, J., Vidal-Jordana, Á., & Pérez-Miralles, F. (2021). Cognitive impairment in multiple sclerosis: Diagnosis and monitoring. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 42(12), 5183–5193. https://doi.org/10.1007/s10072-021-05165-7.
Momenabadi, V., Kaveh, M. H., Nakhaee, N., Shirazi, K., Sedighi, K., B., & Tabatabaei, S. H. R. (2020). Health promoting self-care behaviors in patients with multiple sclerosis in the Southeast of Iran: Developing a model for practice. Basic Clin Neurosci, 11(5), 687–699. https://doi.org/10.32598/bcn.11.5.1670.1.
Nag, N., Yu, M., Jelinek, G. A., Simpson-Yap, S., Neate, S. L., & Schmidt, H. K. (2021). Associations between Lifestyle behaviors and Quality of Life Differ based on multiple sclerosis phenotype. J Pers Med, 11(11). https://doi.org/10.3390/jpm11111218.
Nishimura, H., Ikegami, S., Uehara, M., Takahashi, J., Tokida, R., & Kato, H. (2022). Detection of cognitive decline by spinal posture assessment in health exams of the general older population. Scientific Reports, 12(1), 8460. https://doi.org/10.1038/s41598-022-12605-7.
Nucci, M., Mapelli, D., & Mondini, S. (2012). Cognitive Reserve Index questionnaire (CRIq): A new instrument for measuring cognitive reserve. Aging Clinical and Experimental Research, 24(3), 218–226. https://doi.org/10.3275/7800.
Oset, M., Stasiolek, M., & Matysiak, M. (2020). Cognitive dysfunction in the early stages of multiple sclerosis-how much and how important? Current Neurology and Neuroscience Reports, 20(7), 22. https://doi.org/10.1007/s11910-020-01045-3.
Ozakbas, S., Yigit, P., Akyuz, Z., Sagici, O., Abasiyanik, Z., Ozdogar, A. T., Kahraman, T., Bozan, H. R., Hosgel, I., & Multiple Sclerosis Research Group. (2021). Validity and reliability of Cognitive Reserve Index Questionnaire for the Turkish Population. Multiple Sclerosis and Related Disorders, 50, 102817. https://doi.org/10.1016/j.msard.2021.102817.
Pitrou, I., Vasiliadis, H. M., & Hudon, C. (2022). Body mass index and cognitive decline among community-living older adults: The modifying effect of physical activity. European Review of Aging and Physical Activity : Official Journal of the European Group for Research Into Elderly and Physical Activity, 19(1), 3. https://doi.org/10.1186/s11556-022-00284-2.
Salari, N., Kazeminia, M., Abdi, A., Abdolmaleki, A., Abdoli, N., Mohammadi, M., & Shohaimi, S. (2023). Effects of counselling and spiritual care program on anxiety in patients with chronic diseases: A systematic review and meta-analysis. Current Psychology, 42(12), 9943–9952. https://doi.org/10.1007/s12144-021-02263-9.
Santangelo, G., Altieri, M., Gallo, A., & Trojano, L. (2019). Does cognitive reserve play any role in multiple sclerosis? A meta-analytic study. Multiple Sclerosis and Related Disorders, 30, 265–276. https://doi.org/10.1016/j.msard.2019.02.017.
Šare, S., Ljubičić, M., Gusar, I., Čanović, S., & Konjevoda, S. (2021). Self-Esteem, anxiety, and Depression in older people in nursing homes. Healthcare (Basel), 9(8). https://doi.org/10.3390/healthcare9081035.
Shayganfar, A., Etemadifar, M., Nasr, N., & Mousavi, S. (2019). The relationship between Cognitive disorders and hippocampal Angle in patients multiple sclerosis. Journal of Isfahan Medical School, 37(531), 680–686. https://doi.org/10.22122/jims.v37i531.11976.
Silva, M. V. F., Loures, C. M. G., Alves, L. C. V., de Souza, L. C., Borges, K. B. G., & Carvalho, M. D. G. (2019). Alzheimer’s disease: Risk factors and potentially protective measures. Journal of Biomedical Science, 26(1), 33. https://doi.org/10.1186/s12929-019-0524-y.
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47(10), 2015–2028. https://doi.org/10.1016/j.neuropsychologia.2009.03.004.
Stern, Y., Barnes, C. A., Grady, C., Jones, R. N., & Raz, N. (2019). Brain reserve, cognitive reserve, compensation, and maintenance: Operationalization, validity, and mechanisms of cognitive resilience. Neurobiology of Aging, 83, 124–129. https://doi.org/10.1016/j.neurobiolaging.2019.03.022.
Stolt, M., Laitinen, A. M., Ruutiainen, J., & Leino-Kilpi, H. (2020). Research on lower extremity health in patients with multiple sclerosis: A systematic scoping review. Journal of Foot and Ankle Research, 13(1), 54. https://doi.org/10.1186/s13047-020-00423-x.
Su, S., Shi, L., Zheng, Y., Sun, Y., Huang, X., Zhang, A., Que, J., Sun, X., Shi, J., Bao, Y., Deng, J., & Lu, L. (2022). Leisure activities and the risk of dementia: A systematic review and Meta-analysis. Neurology, 99(15), e1651–1663. https://doi.org/10.1212/wnl.0000000000200929.
Sumowski, J. F., & Leavitt, V. M. (2013). Cognitive reserve in multiple sclerosis. Multiple Sclerosis (Houndmills Basingstoke England), 19(9), 1122–1127. https://doi.org/10.1177/1352458513498834.
Takasugi, T., Tsuji, T., Hanazato, M., Miyaguni, Y., Ojima, T., & Kondo, K. (2021). Community-level educational attainment and dementia: A 6-year longitudinal multilevel study in Japan. BMC Geriatrics, 21(1), 661. https://doi.org/10.1186/s12877-021-02615-x.
Warren, S. L., Reid, E., Whitfield, P., Helal, A. M., Hamza, A., Tindle, E. G., Moustafa, R., A. A., & Hamid, M. S. (2023). Cognitive and behavioral abnormalities in individuals with Alzheimer’s disease, mild cognitive impairment, and subjective memory complaints. Current Psychology. https://doi.org/10.1007/s12144-023-04281-1.
Zülke, A. E., Luppa, M., Köhler, S., & Riedel-Heller, S. G. (2022). Knowledge of risk and protective factors for dementia in older German adults a population-based survey on risk and protective factors for dementia and internet-based brain health interventions. PLoS One, 17(11), e0277037. https://doi.org/10.1371/journal.pone.0277037.
Funding
This study did not receive any funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval
The Ethics Review Board of Payame Noor University, approved the present study.
Informed consent
All participants provided informed consent prior to participation in the study.
Conflicts of interest/Competing interests
The author declares that the author has no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Hajian, Z., Mousavi, S. & Shahsavari, M.R. Relationships between indices of cognitive reserve and cognitive impairment in patients with multiple sclerosis. Curr Psychol 43, 18368–18374 (2024). https://doi.org/10.1007/s12144-024-05629-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-024-05629-x