The non-linear relationship between self-reported cognitive concerns and performance-based cognitive dysfunction in...

Area of Science:

• Neuroscience
• Clinical Neurology
• Psychology

Background:

• Self-reported cognitive concerns (SCC) show a weak and inconsistent relationship with objective cognitive dysfunction in people with multiple sclerosis (pwMS).
• Understanding this relationship is crucial for accurately assessing cognitive health in pwMS.

Purpose of the Study:

• To investigate a potential non-linear relationship between SCC and objectively measured cognitive impairment in pwMS.
• To identify a critical threshold for SCC that predicts cognitive impairment.

Main Methods:

• A cohort of 933 pwMS completed the Minimal Assessment of Cognitive Function in MS (MACFIMS) and the Perceived Deficits Questionnaire (PDQ) for SCC.
• Cognitive impairment was defined as ≥3 MACFIMS scores ≥1.5 SD below normative data.
• Segmented logistic regression was used to analyze the association between PDQ scores and cognitive impairment, controlling for covariates.

Main Results:

• Cognitive impairment was present in 46.73% of the participants.
• A PDQ score of 50 or higher was independently associated with increased odds of cognitive impairment (OR=1.92).
• PDQ scores below 50 did not show a significant association with cognitive impairment (OR=1.03).

Conclusions:

• A critical threshold exists for SCC, above which individuals with multiple sclerosis have significantly higher odds of cognitive impairment.
• These findings suggest that the severity of subjective cognitive complaints is a key factor in predicting objective cognitive deficits in pwMS.