Contributions
Abstract: P1163
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Cognitive status in moderately-sized samples of people with multiple sclerosis (PwMS) is stable across 3years. There is a need for investigations which characterize cognitive decline in larger samples of PwMS and for longer periods of time. Baseline characteristics, such as education level and trait Conscientiousness, moderate the impact of neuropathology on cognition and may affect rates of cognitive decline longitudinally.
Objective: To characterize rates of cognitive decline in PwMS longitudinally and to determine which baseline clinical factors predict rates of decline.
Methods: 613 PwMS were included in a retrospective longitudinal investigation of performance on the Symbol Digit Modalities Test (SDMT). Linear mixed effects models were applied to examine the rates of cognitive decline across time. Then, a separate, analogous analysis was applied to investigate baseline clinical predictors of these rates on a sub-group of 416 PwMS. Covariates in this model included baseline age, sex (female as reference), verbal intelligence, trait Conscientiousness (informant-report when available), and the interaction of these predictors with time.
Results: Subjects under investigation had SDMT measured 2-12 times (mean=2.98) across 13.9 years, with an average (SD) of 2.05(2.52) years between each time point. In the first model, time from baseline evaluation was a statistically significant predictor of SDMT decline, accounting for -0.25 raw score points per year. In predicting SDMT performance, statistically significant main effects were observed for age (t=-4.07, p< 0.001), sex (t=-2.73, p=0.007), verbal intelligence (t=4.81, p< 0.001), trait Conscientiousness (t=3.70, p< 0.001), and time (t=-3.33, p=0.001). A statistically significant time*Conscientiousness interaction was observed (t=2.194, p=0.030), indicating that individuals with higher levels of trait Conscientiousness at baseline exhibited reduced rates of cognitive decline.
Conclusion: On average, PwMS decline 1 point on SDMT in four years and this rate of decline is attenuated for individuals with higher baseline levels of trait Conscientiousness. This may indicate a protective relationship between personality and cognitive decline in PwMS.
Disclosure: Tom Fuchs, Jeta Pol, Michael Jaworski, and Curtis Wojcik have nothing to declare.
Ralph H. B. Benedict has received research support from Accorda, Novartis, Genzyme, Biogen Idec, and Mallinkrodt, and is on the speakers' bureau for EMD Serono, and consults for Biogen Idec, Genentech, Roche, Sanofi/Genzyme, Takeda, NeuroCog Trials, and Novartis. Dr. Benedict also receives royalties for Psychological Assessment Resources.
Michael G. Dwyer has received consultant fees from Claret Medical and EMD Serono and research grant support from Novartis.
Bianca Weinstock-Guttman received honoraria as a speaker and as a consultant for Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme, Sanofi, Novartis and Acorda. Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono,Genzyme, Sanofi, Novartis, Acorda.
Abstract: P1163
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Cognitive status in moderately-sized samples of people with multiple sclerosis (PwMS) is stable across 3years. There is a need for investigations which characterize cognitive decline in larger samples of PwMS and for longer periods of time. Baseline characteristics, such as education level and trait Conscientiousness, moderate the impact of neuropathology on cognition and may affect rates of cognitive decline longitudinally.
Objective: To characterize rates of cognitive decline in PwMS longitudinally and to determine which baseline clinical factors predict rates of decline.
Methods: 613 PwMS were included in a retrospective longitudinal investigation of performance on the Symbol Digit Modalities Test (SDMT). Linear mixed effects models were applied to examine the rates of cognitive decline across time. Then, a separate, analogous analysis was applied to investigate baseline clinical predictors of these rates on a sub-group of 416 PwMS. Covariates in this model included baseline age, sex (female as reference), verbal intelligence, trait Conscientiousness (informant-report when available), and the interaction of these predictors with time.
Results: Subjects under investigation had SDMT measured 2-12 times (mean=2.98) across 13.9 years, with an average (SD) of 2.05(2.52) years between each time point. In the first model, time from baseline evaluation was a statistically significant predictor of SDMT decline, accounting for -0.25 raw score points per year. In predicting SDMT performance, statistically significant main effects were observed for age (t=-4.07, p< 0.001), sex (t=-2.73, p=0.007), verbal intelligence (t=4.81, p< 0.001), trait Conscientiousness (t=3.70, p< 0.001), and time (t=-3.33, p=0.001). A statistically significant time*Conscientiousness interaction was observed (t=2.194, p=0.030), indicating that individuals with higher levels of trait Conscientiousness at baseline exhibited reduced rates of cognitive decline.
Conclusion: On average, PwMS decline 1 point on SDMT in four years and this rate of decline is attenuated for individuals with higher baseline levels of trait Conscientiousness. This may indicate a protective relationship between personality and cognitive decline in PwMS.
Disclosure: Tom Fuchs, Jeta Pol, Michael Jaworski, and Curtis Wojcik have nothing to declare.
Ralph H. B. Benedict has received research support from Accorda, Novartis, Genzyme, Biogen Idec, and Mallinkrodt, and is on the speakers' bureau for EMD Serono, and consults for Biogen Idec, Genentech, Roche, Sanofi/Genzyme, Takeda, NeuroCog Trials, and Novartis. Dr. Benedict also receives royalties for Psychological Assessment Resources.
Michael G. Dwyer has received consultant fees from Claret Medical and EMD Serono and research grant support from Novartis.
Bianca Weinstock-Guttman received honoraria as a speaker and as a consultant for Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme, Sanofi, Novartis and Acorda. Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono,Genzyme, Sanofi, Novartis, Acorda.