TY - JOUR
T1 - Cognitive reserve in multiple sclerosis
T2 - The role of depression and fatigue
AU - Stein, Clara
AU - O’Keeffe, Fiadhnait
AU - Brosnan, Méadhbh
AU - Flynn, Claire
AU - McGuigan, Christopher
AU - Bramham, Jessica
N1 - Publisher Copyright:
© The Author(s), 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
PY - 2025/7
Y1 - 2025/7
N2 - Background: Several reports suggest that cognitive reserve (CR) may protect against cognitive impairment in MS. Fatigue and depression are common in MS. Yet, their influence on engagement with activities that build CR is unclear. Objectives: This study aimed to achieve a better understanding of CR-building in MS, by examining how CR differs in people with MS (pwMS) compared with neurologically healthy individuals and by investigating how common MS symptoms interact with CR-building. Methods: In total, 206 pwMS and 150 age- and gender-matched controls participated in this cross-sectional study. Participants completed self-report measures of CR accumulated in early life and across the lifespan (including education, occupation, cognitively enriching leisure activities), and of cognitive functioning, fatigue, depression, anxiety and MS-impact on everyday life. Results: PwMS’ recent engagement in cognitively enriching leisure activities was negatively associated with self-reported cognitive difficulties (rho = −0.31, p < 0.001). However, after controlling for fatigue and depression, this association was no longer present. Correspondingly, we observed that higher levels of depression were associated with lower engagement in cognitively enriching leisure activities (B = −0.41 (95% confidence interval (CI): −0.61 to −0.22), p < 0.001). Conclusion: Our results highlight the importance of addressing depression and fatigue in the context of lifestyle recommendations.
AB - Background: Several reports suggest that cognitive reserve (CR) may protect against cognitive impairment in MS. Fatigue and depression are common in MS. Yet, their influence on engagement with activities that build CR is unclear. Objectives: This study aimed to achieve a better understanding of CR-building in MS, by examining how CR differs in people with MS (pwMS) compared with neurologically healthy individuals and by investigating how common MS symptoms interact with CR-building. Methods: In total, 206 pwMS and 150 age- and gender-matched controls participated in this cross-sectional study. Participants completed self-report measures of CR accumulated in early life and across the lifespan (including education, occupation, cognitively enriching leisure activities), and of cognitive functioning, fatigue, depression, anxiety and MS-impact on everyday life. Results: PwMS’ recent engagement in cognitively enriching leisure activities was negatively associated with self-reported cognitive difficulties (rho = −0.31, p < 0.001). However, after controlling for fatigue and depression, this association was no longer present. Correspondingly, we observed that higher levels of depression were associated with lower engagement in cognitively enriching leisure activities (B = −0.41 (95% confidence interval (CI): −0.61 to −0.22), p < 0.001). Conclusion: Our results highlight the importance of addressing depression and fatigue in the context of lifestyle recommendations.
KW - Cognitive reserve
KW - depression
KW - fatigue
KW - leisure activities
KW - multiple sclerosis
KW - symptom burden
UR - https://www.scopus.com/pages/publications/105008067392
U2 - 10.1177/13524585251338757
DO - 10.1177/13524585251338757
M3 - Article
C2 - 40501101
AN - SCOPUS:105008067392
SN - 1352-4585
VL - 31
SP - 995
EP - 1006
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 8
ER -