Stein Clara, O'Keeffe Fiadhnait, Brosnan Méadhbh, Flynn Claire, McGuigan Christopher, Bramham Jessica
University College Dublin, Dublin, Ireland.
University College Dublin, Dublin, Ireland; University College Cork, Cork, Ireland.
Mult Scler. 2025 Jul;31(8):995-1006. doi: 10.1177/13524585251338757. Epub 2025 Jun 11.
Several reports suggest that cognitive reserve (CR) may protect against cognitive impairment in MS. Fatigue and depression are common in MS. Yet, their influence on engagement with activities that build CR is unclear.
This study aimed to achieve a better understanding of CR-building in MS, by examining how CR differs in people with MS (pwMS) compared with neurologically healthy individuals and by investigating how common MS symptoms interact with CR-building.
In total, 206 pwMS and 150 age- and gender-matched controls participated in this cross-sectional study. Participants completed self-report measures of CR accumulated in early life and across the lifespan (including education, occupation, cognitively enriching leisure activities), and of cognitive functioning, fatigue, depression, anxiety and MS-impact on everyday life.
PwMS' recent engagement in cognitively enriching leisure activities was negatively associated with self-reported cognitive difficulties (rho = -0.31, < 0.001). However, after controlling for fatigue and depression, this association was no longer present. Correspondingly, we observed that higher levels of depression were associated with lower engagement in cognitively enriching leisure activities ( = -0.41 (95% confidence interval (CI): -0.61 to -0.22), < 0.001).
Our results highlight the importance of addressing depression and fatigue in the context of lifestyle recommendations.
多项报告表明，认知储备（CR）可能预防多发性硬化症（MS）患者的认知障碍。疲劳和抑郁在MS患者中很常见。然而，它们对参与建立CR的活动的影响尚不清楚。
本研究旨在通过比较MS患者（pwMS）与神经功能正常个体的CR差异，以及研究常见的MS症状如何与CR建立相互作用，来更好地理解MS患者的CR建立情况。
共有206名pwMS患者和150名年龄及性别匹配的对照者参与了这项横断面研究。参与者完成了关于早年及一生积累的CR（包括教育、职业、认知丰富的休闲活动）以及认知功能、疲劳、抑郁、焦虑和MS对日常生活影响的自我报告测量。
pwMS患者近期参与认知丰富的休闲活动与自我报告的认知困难呈负相关（rho = -0.31，< 0.001）。然而，在控制疲劳和抑郁后，这种关联不再存在。相应地，我们观察到较高水平的抑郁与参与认知丰富的休闲活动较少相关（= -0.41（95%置信区间（CI）：-0.61至-0.22），< 0.001）。
我们的结果强调了在生活方式建议中解决抑郁和疲劳问题的重要性。
