TY - JOUR
T1 - Cognitive reserve is a determinant of social and occupational attainment in patients with pediatric and adult onset multiple sclerosis
AU - E, Portaccio
AU - M, Simone
AU - E, Prestipino
AU - A, Bellinvia
AU - L, Pastò
AU - Claudia, Niccolai
AU - L, Razzolini
AU - R, Fratangelo
AU - L, Tudisco
AU - M, Fonderico
AU - A, Ghezzi
AU - L, Pippolo
AU - MG, Marrosu
AU - E, Cocco
AU - G, Fenu
AU - F, Patti
AU - C, Chisari
AU - M, Falautano
AU - L, Moiola
AU - E, Minacapelli
AU - RG, Viterbo
AU - L, Margari
AU - B, Goretti
AU - MP, Amato
PY - 2020/7
Y1 - 2020/7
N2 - Background: There is limited information on socio-professional attainment in pediatric-onset multiple sclerosis (POMS) compared with adult-onset MS (AOMS). Objectives: To assess socio-professional outcomes in POMS and AOMS and variables influencing these outcomes. Methods: One-hundred-fifteen AOMS and 111 POMS patients underwent neuropsychological testing (Brief Repeatable Battery, Stroop test), assessment of cognitive reserve (CR) (education, National Adult reading Test –NART, Barratt Simplified Measure of Social Status), fatigue (Fatigue Severity Scale), depression (Montgomery-Åsberg Depression Rating Scale), socio-professional performance (Work and Social Adjustment Scale -WSAS). Prognostic factors were assessed using logistic and linear multivariable regression analyses. Results: 34.5% of patients showed CI without significant differences between AOMS and POMS. Cognitively impaired patients were older (p=0.024), had higher EDSS scores (p=0.041) and lower IQ (p<0.001) compared with cognitively preserved patients. Better WSAS scores were associated with younger age (p=0.007), lower EDSS (p<0.001) and higher educational levels (p=0.001). Fourteen POMS (13%) and six AOMS (5%) achieved a lower educational level compared with their parents (p=0.06). POMS exhibiting a lower than expected educational level, had a lower median IQ compared with the remaining subjects (101 vs 106.5; p=0.03). Unemployment rate was predicted by higher disability (p=0.044) and lower educational levels (p<0.001). Occupational complexity was positively correlated to educational level (<0.001) and NART scores (<0.040). Conclusion: This study underscores the complex relationships between cognition and educational, socioeconomic and professional attainment in MS and supports a protective role of CR in both POMS and AOMS.
AB - Background: There is limited information on socio-professional attainment in pediatric-onset multiple sclerosis (POMS) compared with adult-onset MS (AOMS). Objectives: To assess socio-professional outcomes in POMS and AOMS and variables influencing these outcomes. Methods: One-hundred-fifteen AOMS and 111 POMS patients underwent neuropsychological testing (Brief Repeatable Battery, Stroop test), assessment of cognitive reserve (CR) (education, National Adult reading Test –NART, Barratt Simplified Measure of Social Status), fatigue (Fatigue Severity Scale), depression (Montgomery-Åsberg Depression Rating Scale), socio-professional performance (Work and Social Adjustment Scale -WSAS). Prognostic factors were assessed using logistic and linear multivariable regression analyses. Results: 34.5% of patients showed CI without significant differences between AOMS and POMS. Cognitively impaired patients were older (p=0.024), had higher EDSS scores (p=0.041) and lower IQ (p<0.001) compared with cognitively preserved patients. Better WSAS scores were associated with younger age (p=0.007), lower EDSS (p<0.001) and higher educational levels (p=0.001). Fourteen POMS (13%) and six AOMS (5%) achieved a lower educational level compared with their parents (p=0.06). POMS exhibiting a lower than expected educational level, had a lower median IQ compared with the remaining subjects (101 vs 106.5; p=0.03). Unemployment rate was predicted by higher disability (p=0.044) and lower educational levels (p<0.001). Occupational complexity was positively correlated to educational level (<0.001) and NART scores (<0.040). Conclusion: This study underscores the complex relationships between cognition and educational, socioeconomic and professional attainment in MS and supports a protective role of CR in both POMS and AOMS.
KW - Adult onset multiple sclerosis
KW - Cognitive performances
KW - Cognitive reserve
KW - Pediatric onset multiple sclerosis
KW - Socio-professional outcomes
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U2 - 10.1016/j.msard.2020.102145
DO - 10.1016/j.msard.2020.102145
M3 - Article
AN - SCOPUS:85084377359
VL - 42
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
SN - 2211-0348
M1 - 102145
ER -