INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #20 Clinical Utility of the Ascertain Dementia 8 and the Association of Cognition on Perceived Subjective Cognitive Complaints in Older Adults with Multiple Sclerosis Katie Brundage, Ferkauf Graduate School of Psychology, Yeshiva University, New York, United States Roee Holtzer, Albert Einstein College of Medicine, New York, United States Category: Multiple Sclerosis/ALS/Demyelinating Disorders Keyword 1: aging disorders Keyword 2: multiple sclerosis Keyword 3: memory complaints Objective: There are major gaps in research examining the intersection of aging and Multiple Sclerosis (MS), especially in respect to perceived cognitive changes and their relationship to objective cognitive performance. Subjective Cognitive Complaints (SCCs), linked to cognitive dysfunction in healthy adult and older adult populations, have been under studied in older adults with MS. Notably, the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) has been used to assess SCCs in MS but the Ascertain Dementia 8 (AD8), which is shorter and well-validated in aging cohorts, has not been used in older adults with MS. Therefore, in this study we examined the relationship between the MSNQ and AD8 as well as the associations of both measures with select objective tests of executive functions and memory in older adults with a physician confirmed diagnosis of MS. Participants and Methods: Community dwelling adults aged ≥ 60 years with MS. All participants were dementia-free, as determined via established case conference procedures, received a physician-confirmed diagnosis of MS and were on Disease Modifying Treatment (DMT) for at least 6 months prior to testing. The Oral Symbol Digits Modality Test (SDMT) was used to assess attention/executive functions; the Hopkins Verbal Learning Test -Revised (HVLT-R) was used to assess verbal memory, both immediate and delay recall performances. The AD8, categorized into a two-level variable (0 vs. ≥1) and MSNQ (continuous) were used to assess SCCS. Analyses adjusted for age, sex, education, race, health status, depressive symptoms, and global cognition. Results: The sample (n= 94; mean age= 64.63 ± 4.24; %female= 67.0) included 58 individuals who presented with SCCs. The association between MSNQ and AD8 scores was positive and in the expected direction (β=0.027, p<.001). Presence of SCCs via the AD8 was associated with worse SDMT performance in the unadjusted model (β=-0.100, p=.047), but became insignificant when analysis controlled for covariates. Higher (i.e., more SCCs) scores on the MSNQ were associated with worse HVLT delayed memory performance, but this relationship also became insignificant when analysis was adjusted for covariates (β=-2.667, p=.014). Of note, depressive symptoms were the only covariate that was significantly associated with SDMT in the fully adjusted AD8 model (β=0.040, p<.001) and significantly associated with HVLT Delayed in the fully adjusted MSNQ model (β=1.101, p<.001). Conclusions: Consistent with our prediction, AD8 and MSNQ were correlated in the expected direction providing first and initial validation for the AD8 in this sample of older adults with MS. However, SCCs were inconsistently associated with objective performance on measures of attention/executive functions and verbal memory in unadjusted models, but lost significance in models that controlled for covariates. These findings suggest that SCCs may have differential relationships with cognitive function in older adults with MS, as well as that perception of SCCs may have a differential relationship with depressive symptoms. Endorsement of depressive symptoms in older adults with MS may represent more than just affective distress given the link to both attention/executive function and verbal memory. In addition, given predictive utility of SCCs as risk of cognitive decline within older adults, the relationship between tasks of attention/executive function and memory and SCCs as well as the influence of MS symptom severity on perception of SCCs, requires further study within older adults with MS.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #20

Clinical Utility of the Ascertain Dementia 8 and the Association of Cognition on Perceived Subjective Cognitive Complaints in Older Adults with Multiple Sclerosis

Katie Brundage, Ferkauf Graduate School of Psychology, Yeshiva University, New York, United States
Roee Holtzer, Albert Einstein College of Medicine, New York, United States

Category: Multiple Sclerosis/ALS/Demyelinating Disorders

Keyword 1: aging disorders
Keyword 2: multiple sclerosis
Keyword 3: memory complaints

Objective:

There are major gaps in research examining the intersection of aging and Multiple Sclerosis (MS), especially in respect to perceived cognitive changes and their relationship to objective cognitive performance. Subjective Cognitive Complaints (SCCs), linked to cognitive dysfunction in healthy adult and older adult populations, have been under studied in older adults with MS. Notably, the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) has been used to assess SCCs in MS but the Ascertain Dementia 8 (AD8), which is shorter and well-validated in aging cohorts, has not been used in older adults with MS. Therefore, in this study we examined the relationship between the MSNQ and AD8 as well as the associations of both measures with select objective tests of executive functions and memory in older adults with a physician confirmed diagnosis of MS.

Participants and Methods:

Community dwelling adults aged ≥ 60 years with MS. All participants were dementia-free, as determined via established case conference procedures, received a physician-confirmed diagnosis of MS and were on Disease Modifying Treatment (DMT) for at least 6 months prior to testing. The Oral Symbol Digits Modality Test (SDMT) was used to assess attention/executive functions; the Hopkins Verbal Learning Test -Revised (HVLT-R) was used to assess verbal memory, both immediate and delay recall performances. The AD8, categorized into a two-level variable (0 vs. ≥1) and MSNQ (continuous) were used to assess SCCS. Analyses adjusted for age, sex, education, race, health status, depressive symptoms, and global cognition.

Results:

The sample (n= 94; mean age= 64.63 ± 4.24; %female= 67.0) included 58 individuals who presented with SCCs. The association between MSNQ and AD8 scores was positive and in the expected direction (β=0.027, p<.001). Presence of SCCs via the AD8 was associated with worse SDMT performance in the unadjusted model (β=-0.100, p=.047), but became insignificant when analysis controlled for covariates. Higher (i.e., more SCCs) scores on the MSNQ were associated with worse HVLT delayed memory performance, but this relationship also became insignificant when analysis was adjusted for covariates (β=-2.667, p=.014). Of note, depressive symptoms were the only covariate that was significantly associated with SDMT in the fully adjusted AD8 model (β=0.040, p<.001) and significantly associated with HVLT Delayed in the fully adjusted MSNQ model (β=1.101, p<.001).

Conclusions:

Consistent with our prediction, AD8 and MSNQ were correlated in the expected direction providing first and initial validation for the AD8 in this sample of older adults with MS. However, SCCs were inconsistently associated with objective performance on measures of attention/executive functions and verbal memory in unadjusted models, but lost significance in models that controlled for covariates. These findings suggest that SCCs may have differential relationships with cognitive function in older adults with MS, as well as that perception of SCCs may have a differential relationship with depressive symptoms. Endorsement of depressive symptoms in older adults with MS may represent more than just affective distress given the link to both attention/executive function and verbal memory. In addition, given predictive utility of SCCs as risk of cognitive decline within older adults, the relationship between tasks of attention/executive function and memory and SCCs as well as the influence of MS symptom severity on perception of SCCs, requires further study within older adults with MS.