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. 2022 Aug 5;8(3):20552173221118309.
doi: 10.1177/20552173221118309. eCollection 2022 Jul-Sep.

The relationship between cognition, education, and employment in multiple sclerosis patients

Devon S Conway  1 , Robert A Bermel  1 , Sarah M Planchon  1
Affiliations

The relationship between cognition, education, and employment in multiple sclerosis patients

Devon S Conway et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: Processing speed decline is a common manifestation of multiple sclerosis (MS). The processing speed test (PST) is a validated electronic cognitive assessment based on the Symbol-Digit Modalities Test, which is routinely administered as part of the multi-institutional Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) initiative. The longitudinal relationship between education, processing speed, and employment is unclear.

Objectives: Determine the longitudinal impact of educational attainment on processing speed and employment.

Methods: MS PATHS data through March 2020 were analyzed. Repeat PST assessments at 1, 2, and 3 years were classified as improved, worsened, or stable. Linear regression was used to evaluate the relationship between education and baseline PST performance and logistic regression was used to determine the odds of PST worsening by educational attainment. Employment outcomes were analyzed by PST status and educational level.

Results: There were 13,732 patients analyzed. Education impacted baseline PST scores, but had a limited effect on PST performance over time. Education was protective with respect to employment in the setting of both PST worsening and improvement.

Conclusion: Greater education results in better baseline processing speed and is protective with respect to employment status. Its impact on processing speed over time is marginal.

Keywords: Cognition; multiple sclerosis.

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Conflict of interest statement

Declaration of conflicting interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Conway has received research support paid to his institution by Novartis Pharmaceuticals, EMD Serono, Horizon Therapeutics, and the Department of Defense. He has received compensation for consulting from Novartis Pharmaceuticals and Banner Life Sciences and for speaking from Biogen. Dr Bermel has received research support paid to his institution from Biogen and Genentech. He has received compensation for consulting for Biogen, EMD Serono, Genzyme, Genentech, Novartis, and VielaBio and contributed to intellectual property that is part of the MSPT, for which he may be entitled to royalties. Dr Planchon has received research support from the Guthy Jackson Charitable Foundation. MS PATHS is sponsored by Biogen.®

Figures

Figure 1.
Figure 1.
PST scores over time by educational attainment.
Figure 2.
Figure 2.
Employment outcomes by year among individuals whose PST score worsened from baseline.
Figure 3.
Figure 3.
Employment outcomes by year among individuals whose PST score improved from baseline.
See this image and copyright information in PMC

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