Education Levels May Have a Protective Effect Against Cognitive Impairment Associated with Multiple Sclerosis

New research indicates that patients with multiple sclerosis (MS) who have high levels of education may be less likely to suffer from cognitive impairment related to MS than patients with MS and lower levels of education.

New research indicates that patients with multiple sclerosis (MS) who have high levels of education may be less likely to suffer from cognitive impairment related to MS than patients with MS and lower levels of education.

The authors of “Education Protects against Cognitive Changes Associated with Multiple Sclerosis,” published in Restorative Neurology and Neuroscience, explored “the influence of cognitive reserve proxy indices (education and occupation) and perceived fatigue on cognitive performance” by measuring cognitive performance in patients with relapsing-remitting multiple sclerosis. Investigators used the Paced Auditory Serial Addition Test (PASAT), which enabled them to manipulate information processing speed by varying the presentation speed of stimuli.

According to a news release that accompanied publication of the article, researchers hypothesized that “an individual’s lifetime occupational attainment could also be considered a good proxy of [cognitive reserve], similar to the way in which higher occupational attainment reduces the risk of Alzheimer’s disease.”

In the study, 50 patients with a clinical diagnosis of MS were evaluated via PASAT, which has “high sensitivity in detecting MS-related cognitive deficits as it relies strongly on working memory and information processing speed abilities.” Researchers also assessed patients’ fatigue levels using the Modified Fatigue Impact Scale (MFIS), which measures “the effects of fatigue in terms of physical, cognitive, and psychosocial functioning.”

Seventeen of the patients had completed less than 13 years of schooling; 33 patients had more than 13 years of schooling and had also obtained a college degree.

Patients were also classified as working in “high” or “low” occupations based on “the cognitive complexity and cognitive effort needed to carry out the job efficiently,” and then further classified into one of three groups: low occupation and low education, low occupation and high education, and high occupation and high education.

The researchers reported that “MS patients with low education performed worse than matched healthy controls at faster PASAT speeds. By contrast, no difference was observed between MS patients with high education and matched healthy controls, regardless of PASAT speed. On the other hand, neither occupational attainment nor fatigue had any impact on cognitive deficits in MS.”

Lead investigator Elisabetta Làdavas, PhD, Director of the Center for Studies and Research in Cognitive Neuroscience, Cesena and Professor of Neuropsychology at the Department of Psychology of the University of Bologna, Italy, said, “These results indicate that low education is a risk factor for cognitive impairment in people with neurological disease such as MS, whereas a high educational level could be considered a protective factor from disease-associated cognitive impairment.”