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Cognitive Profiles of Aging in Multiple Sclerosis
Dejan Jakimovski1,2, Bianca Weinstock-Guttman1, Shumita Roy1
1Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo - The State University of New York, Buffalo, NY, United States.
Background:
Increasingly favorable mortality prognosis in multiple sclerosis (MS) raises questions regarding MS-specific cognitive aging and the presence of comorbidities such as Alzheimer's disease (AD).
Objective:
To assess elderly with MS (EwMS) and age-matched healthy controls (HCs) using both MS- and AD-specific psychometrics.
Methods:
EwMS (n = 104) and 56 HCs were assessed on a broad spectrum of language, visual-spatial processing, memory, processing speed, and executive function tests. Using logistic regression analysis, we examined cognitive performance differences between the EwMS and HC groups. Cognitive impairment (CI) was defined using a -1.5 SD threshold relative to age and education years-matched HCs, in two cognitive domains.
Results:
CI was observed in 47.1% of EwMS with differences most often seen on tests emphasizing cognitive processing speed as measured by Symbol Digit Modalities Test (SDMT) (d = 0.9, p < 0.001) and verbal fluency (both category-based d = 0.87, p < 0.001; letter-based d = 0.67, p < 0.001). After adjusting for age, sex and years of education, MS/HC diagnosis was best predicted (R 2 = 0.27) by differences in category-based verbal fluency (Wald = 9.935, p = 0.002) and SDMT (Wald = 13.937, p < 0.001).
Conclusion:
This study confirms the common hallmark of slowed cognitive processing speed in MS among elderly patients. Defective verbal fluency, less often observed in younger cohorts, may represent emerging cognitive pathology due to other etiologies.
Insights
Cognitive impairment is common in elderly with multiple sclerosis (MS), particularly affecting processing speed and verbal fluency. These findings highlight the need to monitor cognitive aging in MS patients.
Area of Science:
- Neurology
- Neuropsychology
- Gerontology
Background:
- Improved survival in multiple sclerosis (MS) necessitates understanding cognitive aging and comorbidities like Alzheimer's disease (AD).
- The cognitive profile of elderly individuals with MS (EwMS) requires detailed investigation.
Purpose of the Study:
- To compare cognitive performance in elderly with MS (EwMS) against age-matched healthy controls (HCs).
- To utilize both MS- and AD-specific psychometric assessments to evaluate cognitive function.
Main Methods:
- EwMS (n=104) and HCs (n=56) underwent comprehensive cognitive testing across multiple domains.
- Logistic regression analyzed cognitive differences, defining cognitive impairment (CI) as -1.5 SD below HC performance in two domains.
Main Results:
- Cognitive impairment (CI) was identified in 47.1% of EwMS.
- Processing speed (Symbol Digit Modalities Test) and verbal fluency (category and letter-based) showed significant deficits.
- Category-based verbal fluency and SDMT scores effectively predicted MS/HC diagnosis (R²=0.27).
Conclusions:
- Slowed cognitive processing speed is a key feature of aging in multiple sclerosis.
- Impaired verbal fluency, more prevalent in older MS patients, may indicate additional cognitive pathologies.
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