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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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Self-reported cognitive function mediates the relationship between employment status and cognitive functioning in
Adrian I Espiritu1, Yasmin Soliman2, Mervin Blair3
1Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada; Department of Psychiatry and Department of Medicine (Division of Neurology), University of Toronto, Toronto, Ontario, Canada; Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines; Concussion Canadian Center, University Health Network, University of Toronto, Toronto, ON, Canada.
Multiple Sclerosis and Related Disorders
|May 18, 2024
Summary
Self-reported cognitive impairment in people with MS partially explains employment status effects on cognitive performance. Depression can also influence this relationship, highlighting the importance of considering employment and mood when interpreting self-reported cognitive issues.
Area of Science:
- Neuroscience
- Psychology
- Rehabilitation Medicine
Background:
- Cognitive impairment (CI) is prevalent in people with multiple sclerosis (PwMS), impacting their daily lives and employment.
- The relationship between self-reported CI, objective cognitive performance, and employment status in PwMS is not fully understood.
- Self-reported CI may be influenced by factors like depression, potentially affecting its reliability as a sole indicator of cognitive function.
Purpose of the Study:
- To investigate if employment status affects cognitive function in PwMS.
- To determine if self-reported CI mediates the relationship between employment status and objective cognitive performance.
- To examine the moderating role of depression in the association between self-reported CI and cognitive performance.
Main Methods:
- Retrospective analysis of 590 PwMS using the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), Hospital Anxiety and Depression Scale-depression scale (HADS-D), and Minimal Assessment of Cognitive Function in MS (MACFIMS).
- Structural equation modeling (SEM) was employed to analyze the complex relationships between employment status, self-reported CI, depression, and cognitive outcomes (memory, executive functioning, processing speed).
- PwMS were categorized as employed or unemployed, and statistical models tested for mediation and moderation effects.
Main Results:
- Employed PwMS demonstrated significantly better performance in memory, executive functioning, and processing speed compared to unemployed individuals.
- Self-reported CI (MSNQ) partially mediated the impact of employment status on memory, executive functioning, and processing speed.
- Depression (HADS-D) moderated the association between self-reported CI and cognitive performance, indicating a stronger link between subjective and objective measures in those with higher depression scores.
Conclusions:
- Self-reported cognitive impairment partially accounts for why employment status influences objective cognitive performance in PwMS.
- Depression plays a significant role in moderating the relationship between subjective and objective cognitive assessments.
- Employment status and mood are crucial factors to consider when interpreting self-reported cognitive difficulties in individuals with MS.
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