Cognitive reserve and patient-reported outcomes in multiple sclerosis

Multiple Sclerosis Journal, 05/29/2012

This expanded measurement of cognitive reserve captures both the passive and active aspects of the construct, and there is a consistent and substantial relationship with PROs. Individuals with high passive and/or active reserve are healthier and experience higher levels of well–being.

Methods

  • Cross-sectional data (n=1142) were drawn from the North American Research Committee on MS (NARCOMS) Registry, from whom additional survey data were collected.
  • Cognitive reserve was measured using the Stern and Sole-Padulles measures, the O*NET occupational classification system, and the Godin Leisure-Time Exercise Questionnaire.
  • PROs were assessed using generic (SF -12v2, Perceived Deficits Questionnaire, Ryff Psychological Well-Being, Diener Satisfaction with Life Scale) and disease-specific (Patient-Determined Disease Steps, Performance Scales) measures.
  • Psychometric analysis created unidimensional cognitive reserve subscales.
  • Regression models examined relationships between cognitive reserve, demographic characteristics, and PROs.

Results

  • The cognitive reserve measures assessed distinct but related constructs.
  • Individuals with high cognitive reserve were more likely to report lower levels of perceived disability and perceived cognitive deficits, and higher levels of physical health, mental health, and well-being.
  • Both active and passive reserve are associated with better outcomes, independent of demographic factors, and these associations apply to both generic and disease-specific outcomes.

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