Highlights
- •AOMS and POMS exhibit Cognitive Impairment dissociated from physical disability.
- •Cognitive Reserve has a protective role on CI in MS.
- •POMS experience a drop off in educational level based on parental education.
- •Relationships exist between cognition, socioeconomic, professional attainment in MS
ABSTRACT
Background
There is limited information on socio-professional attainment in pediatric-onset multiple
sclerosis (POMS) compared with adult-onset MS (AOMS).
Objectives
To assess socio-professional outcomes in POMS and AOMS and variables influencing these
outcomes.
Methods
One-hundred-fifteen AOMS and 111 POMS patients underwent neuropsychological testing
(Brief Repeatable Battery, Stroop test), assessment of cognitive reserve (CR) (education,
National Adult reading Test –NART, Barratt Simplified Measure of Social Status), fatigue
(Fatigue Severity Scale), depression (Montgomery-Åsberg Depression Rating Scale),
socio-professional performance (Work and Social Adjustment Scale -WSAS). Prognostic
factors were assessed using logistic and linear multivariable regression analyses.
Results
34.5% of patients showed CI without significant differences between AOMS and POMS.
Cognitively impaired patients were older (p=0.024), had higher EDSS scores (p=0.041)
and lower IQ (p<0.001) compared with cognitively preserved patients. Better WSAS scores
were associated with younger age (p=0.007), lower EDSS (p<0.001) and higher educational
levels (p=0.001). Fourteen POMS (13%) and six AOMS (5%) achieved a lower educational
level compared with their parents (p=0.06). POMS exhibiting a lower than expected
educational level, had a lower median IQ compared with the remaining subjects (101
vs 106.5; p=0.03). Unemployment rate was predicted by higher disability (p=0.044)
and lower educational levels (p<0.001). Occupational complexity was positively correlated
to educational level (<0.001) and NART scores (<0.040).
Conclusion
This study underscores the complex relationships between cognition and educational,
socioeconomic and professional attainment in MS and supports a protective role of
CR in both POMS and AOMS.
Keywords
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Article info
Publication history
Published online: May 04, 2020
Accepted:
April 21,
2020
Received in revised form:
April 7,
2020
Received:
February 28,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
