Reserve-building activities in multiple sclerosis patients and healthy controls: a descriptive study.
BACKGROUND
Cognitive reserve has been implicated as a possible protective factor in multiple sclerosis (MS) but to date no study has compared reserve-building activities across disease course or to healthy controls. This study aims to describe differences in reserve-building activities across the MS disease course and healthy controls.


METHODS
Secondary analysis of a cross-sectional cohort study that included 276 healthy controls, and subjects with clinically isolated syndrome (CIS; n = 67), relapsing-remitting MS (RRMS; n = 358) and secondary progressive MS (PMS; n = 109). Past reserve-building activities were operationalized as occupational attainment and education. Current activities comprised 6 strenuous and 6 non-strenuous activities, including 5 reserve-building activities and television-watching. Multivariate Analysis of Variance models examined group differences in past and current activities, after adjusting for covariates.


RESULTS
There were group differences in past and current reserve-building activities. SPMS patients had lower past reserve-building activities than healthy controls. All forms of MS engaged in fewer strenuous current reserve-building pursuits than healthy controls. RRMS read less than healthy controls. SPMS engaged in fewer job-related non-strenuous activities. All MS groups watched more television than healthy controls.


CONCLUSIONS
MS patients show significantly fewer past and present reserve-building activities. Although it is difficult to establish causality without future prospective studies, lifestyle-modifying interventions should prioritize expanding MS patients' repertoire of strenuous and non-strenuous activities.
DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA. carolyn.schwartz@deltaquest.org.|Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA. carolyn.schwartz@deltaquest.org.
Carolyn E
CE
Schwartz
DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA. aayandeh@gmail.com.
Armon
A
Ayandeh
Department of Pharmaceutical Sciences, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA. Murali@Buffalo.edu.|Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA. Murali@Buffalo.edu.
Murali
M
Ramanathan
Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA. benedict@buffalo.edu.
Ralph
R
Benedict
Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA. mgdwyer@bnac.net.|Department of Biomedical Informatics, University of Buffalo, State University of New York, Buffalo, NY, USA. mgdwyer@bnac.net.
Michael G
MG
Dwyer
Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA. BWeinstock-Guttman@kaleidahealth.org.
Bianca
B
Weinstock-Guttman
Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA. rzivadinov@bnac.net.|MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA. rzivadinov@bnac.net.
Robert
R
Zivadinov
D000328:Adult; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D020528:Multiple Sclerosis, Chronic Progressive / Q000534:rehabilitation*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000534:rehabilitation*; D015999:Multivariate Analysis; D009788:Occupational Therapy; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013690:Television