INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #23 Association of Residualized Cognitive Reserve on Cognitive Function in Older Adults with Multiple Sclerosis Andrew Fox, Yeshiva University, Bronx, United States Mark Wagshul, Albert Einstein College of Medicine, Bronx, United States Roee Holtzer, Yeshiva University/Albert Einstein College of Medicine, Bronx, United States Category: Multiple Sclerosis/ALS/Demyelinating Disorders Keyword 1: multiple sclerosis Keyword 2: aging (normal) Keyword 3: cognitive reserve Objective: Cognitive impairment is a prevalent symptom of multiple sclerosis (MS), with older adults exhibiting a greater risk for functional decline. Cognitive reserve (CR) is often proposed as a protective mechanism against age-and disease-related cognitive impairment. However, the role of CR in older adults with MS is not well established. While sociodemographic proxies of CR, such as education and vocabulary proficiency, have been used extensively in MS literature, the residual approach has been underutilized. This empirically supported method regresses out variance associated with demographic and brain pathology measures that contribute to performance on tests of cognition, with the extracted residuals operationalized as CR. The current study addressed gaps in the literature by examining associations of residualized CR with cognitive outcomes commonly impacted by MS (e.g., memory, speed of processing, and executive function). Additionally, this study further examined whether the presence of MS moderated these relationships. Participants and Methods: Participants were dementia-free older adults with a physician-confirmed diagnosis of MS (n = 88, mean age = 64.73 ± 4.25, %female = 65.9) and healthy controls (n = 88, mean age = 69.87 ± 6.93; %female = 67.0) enrolled in an ongoing cohort study. Participants underwent neuropsychological testing and magnetic resonance imaging (MRI) of the brain. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used as the outcome measure for calculating CR. Speed of processing was assessed using the oral version of the Symbol Digit Modalities Test (SDMT). Derived scores from the Trail Making Test (TMT) were used as a measure of executive function (e.g., B:A). Memory (immediate and delayed recall) was assessed using the revised version of the Hopkins Verbal Learning Test (HVLT-R). Questionnaires assessing depression and disease-burden were also administered. Results: CR was defined as the unaccounted standardized residual variance following regression of sociodemographic variables and structural brain integrity on the RBANS total score. The final regression model was statistically significant and accounted for 12.2% of the variance (R = .370, R² = .122, p < .001). Fully adjusted linear regression models revealed significant associations between CR and SDMT (b = 4.72, 95% CI [3.01, 6.43], p < .01), TMT (b = -.70, 95% CI [-1.32, -.07], p = .03), HVLT-R immediate recall (b = 2.04, 95% CI [1.26, 2.83], p < .01), and HVLT-R delayed recall (b = 1.67, 95% CI [1.13, 2.20], p < .01). Furthermore, significant associations were noted between group status (i.e., MS vs Control) and performance on processing speed (b = -3.11, 95% CI [-5.98, -.24], p = .03) and immediate recall (b = -1.50, 95% CI [-2.81, -.16], p = .03). No interaction effects between CR and group status were found. Conclusions: Utilizing the residual approach, the current study found that higher CR was associated with better cognitive performance irrespective of MS disease status. This suggests that the protective effects of CR in older adults are not limited by the presence of a neurological disease.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #23

Association of Residualized Cognitive Reserve on Cognitive Function in Older Adults with Multiple Sclerosis

Andrew Fox, Yeshiva University, Bronx, United States
Mark Wagshul, Albert Einstein College of Medicine, Bronx, United States
Roee Holtzer, Yeshiva University/Albert Einstein College of Medicine, Bronx, United States

Category: Multiple Sclerosis/ALS/Demyelinating Disorders

Keyword 1: multiple sclerosis
Keyword 2: aging (normal)
Keyword 3: cognitive reserve

Objective:

Cognitive impairment is a prevalent symptom of multiple sclerosis (MS), with older adults exhibiting a greater risk for functional decline. Cognitive reserve (CR) is often proposed as a protective mechanism against age-and disease-related cognitive impairment. However, the role of CR in older adults with MS is not well established. While sociodemographic proxies of CR, such as education and vocabulary proficiency, have been used extensively in MS literature, the residual approach has been underutilized. This empirically supported method regresses out variance associated with demographic and brain pathology measures that contribute to performance on tests of cognition, with the extracted residuals operationalized as CR. The current study addressed gaps in the literature by examining associations of residualized CR with cognitive outcomes commonly impacted by MS (e.g., memory, speed of processing, and executive function). Additionally, this study further examined whether the presence of MS moderated these relationships.

Participants and Methods:

Participants were dementia-free older adults with a physician-confirmed diagnosis of MS (n = 88, mean age = 64.73 ± 4.25, %female = 65.9) and healthy controls (n = 88, mean age = 69.87 ± 6.93; %female = 67.0) enrolled in an ongoing cohort study. Participants underwent neuropsychological testing and magnetic resonance imaging (MRI) of the brain. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used as the outcome measure for calculating CR. Speed of processing was assessed using the oral version of the Symbol Digit Modalities Test (SDMT). Derived scores from the Trail Making Test (TMT) were used as a measure of executive function (e.g., B:A). Memory (immediate and delayed recall) was assessed using the revised version of the Hopkins Verbal Learning Test (HVLT-R). Questionnaires assessing depression and disease-burden were also administered.

Results:

CR was defined as the unaccounted standardized residual variance following regression of sociodemographic variables and structural brain integrity on the RBANS total score. The final regression model was statistically significant and accounted for 12.2% of the variance (R = .370, R² = .122, p < .001). Fully adjusted linear regression models revealed significant associations between CR and SDMT (b = 4.72, 95% CI [3.01, 6.43], p < .01), TMT (b = -.70, 95% CI [-1.32, -.07], p = .03), HVLT-R immediate recall (b = 2.04, 95% CI [1.26, 2.83], p < .01), and HVLT-R delayed recall (b = 1.67, 95% CI [1.13, 2.20], p < .01). Furthermore, significant associations were noted between group status (i.e., MS vs Control) and performance on processing speed (b = -3.11, 95% CI [-5.98, -.24], p = .03) and immediate recall (b = -1.50, 95% CI [-2.81, -.16], p = .03). No interaction effects between CR and group status were found.

Conclusions:

Utilizing the residual approach, the current study found that higher CR was associated with better cognitive performance irrespective of MS disease status. This suggests that the protective effects of CR in older adults are not limited by the presence of a neurological disease.