| Multiple Sclerosis (MS) is a chronic, often disabling disease of the central nervous system (CNS). The disease process produces a wide variety of physical, emotional and cognitive symptoms. Cognitive impairment accompanying MS has been well documented. The current study was designed to examine clinical and demographic variables as predictors of dementia in MS. In addition, the potential of education to act as a "buffer" against dementia in this population, as has been found in the Alzheimer's population was examined.;A comprehensive neuropsychological battery including measures of attention, verbal and visual memory, language functions, manual speed and dexterity, visuospatial perception, executive functioning and self-reported depression was administered to 132 MS patients with relapsing disease course. Participants were divided into high (n = 74) and low (n = 58) education groups based on years of education completed. They were also divided into high (n = 73) and low (n = 59) depression groups based on Beck Depression Inventory scores. It was expected that participants with lower levels of education would perform significantly worse, and that there would be an interaction effect for education and depression such that participants with lower levels of education and higher levels of depression would also perform significantly worse. Level of education and level of depression served as independent variables in ANCOVAs in which neuropsychological test scores were dependent variables and time since diagnosis, a marker of disease severity, was entered as the covariate. Within group correlations and interactions with the covariate were also run.;Education was related to cognitive performance; participants with higher levels of education performed significantly better on measures of executive functioning and a measure of verbal learning/memory. However, level of education did not buffer against loss of overall or specific cognitive functioning. There was a trend that indicated a possible buffer effect against loss of executive functioning. Two unexpected findings emerged. Participants in the low education, low depression group performed significantly worse on a measure of verbal learning/memory; and cognitive performance was enriched by use of anxiolytics and Avonex (a MS-specific medication). Implications and future directions are discussed. |
