Occupational Attainment as a Marker of Cognitive Reserve in Multiple Sclerosis

Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant variance in cognition between individual MS patients remains unexplained. Recently, markers of cognitive reserve such as premorbid intelligence have...

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Published in:	PloS one Vol. 7; no. 10; p. e47206
Main Authors:	Ghaffar, Omar, Fiati, Marty, Feinstein, Anthony
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 05.10.2012 Public Library of Science (PLoS)
Subjects:	Adult Alzheimer's disease Atrophy Biology Brain Brain - pathology Brain research Cognition Cognition Disorders - etiology Cognitive ability Cognitive disorders Cognitive Reserve Data processing Education Executive function Female Health sciences Humans Hypotheses Information processing Intelligence Intelligence Tests Magnetic resonance imaging Male Medical research Medicine Memory Middle Aged Multiple sclerosis Multiple Sclerosis - complications Multiple Sclerosis - physiopathology Neuropsychological Tests NMR Nuclear magnetic resonance Occupations Older people Pathology Patients Psychiatry
ISSN:	1932-6203, 1932-6203
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Abstract	Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant variance in cognition between individual MS patients remains unexplained. Recently, markers of cognitive reserve such as premorbid intelligence have emerged as important predictors of neuropsychological performance in MS. In the present study, we aimed to extend the cognitive reserve construct by examining the potential contribution of occupational attainment to cognitive decline in MS patients. Brain atrophy, estimated premorbid IQ, and occupational attainment were assessed in 72 MS patients. The Minimal Assessment of Cognitive Functioning in MS was used to evaluate indices of information processing speed, memory, and executive function. Results showed that occupational attainment was a significant predictor of information processing speed, memory, and executive function in hierarchical linear regressions after accounting for brain atrophy and premorbid IQ. These data suggest that MS patients with low occupational attainment fare worse cognitively than those with high occupational attainment after controlling for brain atrophy and premorbid IQ. Occupation, like premorbid IQ, therefore may make an independent contribution to cognitive outcome in MS. Information regarding an individual's occupation is easily acquired and may serve as a useful proxy for cognitive reserve in clinical settings.
AbstractList	Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant variance in cognition between individual MS patients remains unexplained. Recently, markers of cognitive reserve such as premorbid intelligence have emerged as important predictors of neuropsychological performance in MS. In the present study, we aimed to extend the cognitive reserve construct by examining the potential contribution of occupational attainment to cognitive decline in MS patients. Brain atrophy, estimated premorbid IQ, and occupational attainment were assessed in 72 MS patients. The Minimal Assessment of Cognitive Functioning in MS was used to evaluate indices of information processing speed, memory, and executive function. Results showed that occupational attainment was a significant predictor of information processing speed, memory, and executive function in hierarchical linear regressions after accounting for brain atrophy and premorbid IQ. These data suggest that MS patients with low occupational attainment fare worse cognitively than those with high occupational attainment after controlling for brain atrophy and premorbid IQ. Occupation, like premorbid IQ, therefore may make an independent contribution to cognitive outcome in MS. Information regarding an individual's occupation is easily acquired and may serve as a useful proxy for cognitive reserve in clinical settings. Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant variance in cognition between individual MS patients remains unexplained. Recently, markers of cognitive reserve such as premorbid intelligence have emerged as important predictors of neuropsychological performance in MS. In the present study, we aimed to extend the cognitive reserve construct by examining the potential contribution of occupational attainment to cognitive decline in MS patients. Brain atrophy, estimated premorbid IQ, and occupational attainment were assessed in 72 MS patients. The Minimal Assessment of Cognitive Functioning in MS was used to evaluate indices of information processing speed, memory, and executive function. Results showed that occupational attainment was a significant predictor of information processing speed, memory, and executive function in hierarchical linear regressions after accounting for brain atrophy and premorbid IQ. These data suggest that MS patients with low occupational attainment fare worse cognitively than those with high occupational attainment after controlling for brain atrophy and premorbid IQ. Occupation, like premorbid IQ, therefore may make an independent contribution to cognitive outcome in MS. Information regarding an individual's occupation is easily acquired and may serve as a useful proxy for cognitive reserve in clinical settings.Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant variance in cognition between individual MS patients remains unexplained. Recently, markers of cognitive reserve such as premorbid intelligence have emerged as important predictors of neuropsychological performance in MS. In the present study, we aimed to extend the cognitive reserve construct by examining the potential contribution of occupational attainment to cognitive decline in MS patients. Brain atrophy, estimated premorbid IQ, and occupational attainment were assessed in 72 MS patients. The Minimal Assessment of Cognitive Functioning in MS was used to evaluate indices of information processing speed, memory, and executive function. Results showed that occupational attainment was a significant predictor of information processing speed, memory, and executive function in hierarchical linear regressions after accounting for brain atrophy and premorbid IQ. These data suggest that MS patients with low occupational attainment fare worse cognitively than those with high occupational attainment after controlling for brain atrophy and premorbid IQ. Occupation, like premorbid IQ, therefore may make an independent contribution to cognitive outcome in MS. Information regarding an individual's occupation is easily acquired and may serve as a useful proxy for cognitive reserve in clinical settings.
Audience	Academic
Author	Feinstein, Anthony Fiati, Marty Ghaffar, Omar
AuthorAffiliation	Federal University of Rio de Janeiro, Brazil 1 Neuropsychiatry and Brain Sciences Programs, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada 3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada 2 Neuropsychiatry Services, Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada
AuthorAffiliation_xml	– name: 2 Neuropsychiatry Services, Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada – name: Federal University of Rio de Janeiro, Brazil – name: 3 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada – name: 1 Neuropsychiatry and Brain Sciences Programs, Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Copyright	COPYRIGHT 2012 Public Library of Science Ghaffar et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2012 Ghaffar et al 2012 Ghaffar et al
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: AF served on the scientific advisory boards of Merck/Serono and Avenir Pharmaceuticals; received travel funding from Merck/Serono, Teva Neuroscience, Bayer-Schering, and Biogen; served on the editorial boards of Multiple Sclerosis and the African Journal of Psychiatry; received publishing royalties from Cambridge University Press; received honoraria for speaking engagements or educational activities from Merck/Serono, Teva Neuroscience, Bayer-Schering, and Biogen; serves on the Medical Advisory Committee of the Multiple Sclerosis Society of Canada; and received research support from Teva Neuroscience, Merck-Serono, the Canadian Institutes of Health Research, the University of Toronto, and the Multiple Sclerosis Society of Canada. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors. MF has no competing interests to declare. Conceived and designed the experiments: AF OG. Performed the experiments: OG MF. Analyzed the data: AF OG MF. Contributed reagents/materials/analysis tools: OG. Wrote the paper: AF OG MF.
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Snippet	Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant...
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SubjectTerms	Adult Alzheimer's disease Atrophy Biology Brain Brain - pathology Brain research Cognition Cognition Disorders - etiology Cognitive ability Cognitive disorders Cognitive Reserve Data processing Education Executive function Female Health sciences Humans Hypotheses Information processing Intelligence Intelligence Tests Magnetic resonance imaging Male Medical research Medicine Memory Middle Aged Multiple sclerosis Multiple Sclerosis - complications Multiple Sclerosis - physiopathology Neuropsychological Tests NMR Nuclear magnetic resonance Occupations Older people Pathology Patients Psychiatry
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Title	Occupational Attainment as a Marker of Cognitive Reserve in Multiple Sclerosis
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