Contributions
Abstract: P1097
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Background: Recent data suggest that low education attainment is associated with lower cognitive reserve and increased risk of progressive disability in multiple sclerosis (MS). The aim of this study is to explore the effects of education level on the cognitive performance in a Brazilian cohort of MS-patients.
Methods: The study included 136 MS patients and 65 matched healthy controls (HC), classified in eight education levels, according to Brazilian education structure and divided in low-education (≤ 12 years of education) and high-education (> 12 years) groups. Subjects underwent extensive neuropsychological tests examining seven cognitive domains: verbal memory, visuospatial memory, executive function, information processing speed (IPS), working memory, attention and intelligence coefficient (IQ). Test results were converted to standard z-scores. Subjects that had z-scores lower than -1.5 in two or more domains were considered cognitively impaired (CI). Average cognition was defined by averaging the z-scores of all domains. We analysed the frequency of cognitive impairment in the MS groups and applied automatic linear modeling (IBM SPSS Statistics, Version 23) to the patients' group using average cognition as target; education level, Expanded Disability Status Scale (EDSS) scores, T2 lesion loads, disease duration, age of disease onset, age and gender as predictors. In the HC group, automatic linear modeling included only age, gender and education level as predictors. To determine the cognitive domains more affected in the different education level groups in HC and MS patients, we applied automatic linear modeling using the education group as target and the performance in each domain as predictors, correcting for age and gender.
Results: The low-education group had a higher frequency (57.5%) of CI patients, compared to the high-education group (22.5%). Worse average cognition was associated with higher T2-lesion load, lower education level and male sex. The low-education group had higher EDSS and T2-lesion load. In MS-patients, lower education level was associated with lower IQ, worse information processing speed and visuospatial memory. In the HC, lower education was associated with worse verbal memory, attention, executive function and a lower IQ.
Conclusion: Low education levels are associated with worse cognitive performance and higher disability, suggesting lower cognitive reserve and higher susceptibility to negative effects of disease burden.
Disclosure: Carolina M Rimkus receives a research grant from São Paulo Research Foundation (FAPESP 2014/23299-4).
Isabella Avolio has nothing to disclose.
Elliane C Miotto has nothing to disclose.
Samira L Apostolos Pereira received speaker honoraria from Genzyme.
Maria Fernanda Mendes received speaker honoraria from Roche and Biogen.
Dagoberto Callegaro has nothing to disclose.
Claudia da Costa Leite receives a research grant from General Electrical (GE).
Abstract: P1097
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Background: Recent data suggest that low education attainment is associated with lower cognitive reserve and increased risk of progressive disability in multiple sclerosis (MS). The aim of this study is to explore the effects of education level on the cognitive performance in a Brazilian cohort of MS-patients.
Methods: The study included 136 MS patients and 65 matched healthy controls (HC), classified in eight education levels, according to Brazilian education structure and divided in low-education (≤ 12 years of education) and high-education (> 12 years) groups. Subjects underwent extensive neuropsychological tests examining seven cognitive domains: verbal memory, visuospatial memory, executive function, information processing speed (IPS), working memory, attention and intelligence coefficient (IQ). Test results were converted to standard z-scores. Subjects that had z-scores lower than -1.5 in two or more domains were considered cognitively impaired (CI). Average cognition was defined by averaging the z-scores of all domains. We analysed the frequency of cognitive impairment in the MS groups and applied automatic linear modeling (IBM SPSS Statistics, Version 23) to the patients' group using average cognition as target; education level, Expanded Disability Status Scale (EDSS) scores, T2 lesion loads, disease duration, age of disease onset, age and gender as predictors. In the HC group, automatic linear modeling included only age, gender and education level as predictors. To determine the cognitive domains more affected in the different education level groups in HC and MS patients, we applied automatic linear modeling using the education group as target and the performance in each domain as predictors, correcting for age and gender.
Results: The low-education group had a higher frequency (57.5%) of CI patients, compared to the high-education group (22.5%). Worse average cognition was associated with higher T2-lesion load, lower education level and male sex. The low-education group had higher EDSS and T2-lesion load. In MS-patients, lower education level was associated with lower IQ, worse information processing speed and visuospatial memory. In the HC, lower education was associated with worse verbal memory, attention, executive function and a lower IQ.
Conclusion: Low education levels are associated with worse cognitive performance and higher disability, suggesting lower cognitive reserve and higher susceptibility to negative effects of disease burden.
Disclosure: Carolina M Rimkus receives a research grant from São Paulo Research Foundation (FAPESP 2014/23299-4).
Isabella Avolio has nothing to disclose.
Elliane C Miotto has nothing to disclose.
Samira L Apostolos Pereira received speaker honoraria from Genzyme.
Maria Fernanda Mendes received speaker honoraria from Roche and Biogen.
Dagoberto Callegaro has nothing to disclose.
Claudia da Costa Leite receives a research grant from General Electrical (GE).