Vervoordt Samantha M, Bradson Megan L, Arnett Peter A
Department of Psychology, The Pennsylvania State University, University Park, PA, USA.
Arch Clin Neuropsychol. 2022 Oct 19;37(7):1527-1535. doi: 10.1093/arclin/acac049.
The goal of this study was to determine the impact of the relationship between cognitive reserve and coping strategy on quality of life (QoL) outcomes in persons with MS (PwMS) across multiple domains.
We examined the effect of the interactions between coping style and cognitive reserve on QoL and disease burden in 97 persons with MS (PwMS). Coping strategy, either active or avoidant, was measured using the COPE inventory. We defined cognitive reserve as a composite measure of years of education and scores on the Shipley-2 Vocabulary subtest. QoL and disease burden were assessed using the Functional Assessment of MS (FAMS) scale and the Expanded Disability Status Scale, respectively. We examined both the FAMS individual subscales and the overall QoL score.
For those with higher cognitive reserve, greater avoidant coping was associated with lower QoL for the thinking and fatigue subscale (p < 0.001) and poorer overall QoL (p = 0.03); greater active coping was associated with poorer QoL for mobility (p = 0.001). However, these associations did not hold for those with lower cognitive reserve. Furthermore, there were no associations between coping strategy and cognitive reserve with disease burden.
This study extends previous findings by demonstrating that avoidant coping, rather than active coping, is associated with poorer thinking and fatigue and overall QoL only for PwMS with greater cognitive reserve. Counseling PwMS on the impact of coping strategies on QoL outcomes, especially for those with greater cognitive reserve, may improve quality of life outcomes in this population.
本研究的目的是确定认知储备与应对策略之间的关系对多领域多发性硬化症患者（PwMS）生活质量（QoL）结果的影响。
我们研究了应对方式与认知储备之间的相互作用对97例多发性硬化症患者（PwMS）的生活质量和疾病负担的影响。使用应对方式问卷（COPE inventory）测量应对策略，分为积极应对或回避应对。我们将认知储备定义为受教育年限和Shipley-2词汇子测试分数的综合指标。分别使用多发性硬化症功能评估量表（FAMS）和扩展残疾状态量表评估生活质量和疾病负担。我们研究了FAMS的各个子量表和总体生活质量得分。
对于认知储备较高的患者，更多的回避应对与思维和疲劳子量表的较低生活质量相关（p < 0.001）以及总体生活质量较差（p = 0.03）；更多的积极应对与运动能力方面较差的生活质量相关（p = 0.001）。然而，对于认知储备较低的患者，这些关联并不成立。此外，应对策略和认知储备与疾病负担之间没有关联。
本研究扩展了先前的研究结果，表明回避应对而非积极应对仅与认知储备较高的多发性硬化症患者较差的思维、疲劳和总体生活质量相关。向多发性硬化症患者咨询应对策略对生活质量结果的影响，特别是对于那些认知储备较高的患者，可能会改善该人群的生活质量结果。
