Cognitive Reserve and Its Contribution to Predicting Cognitive Performance in Multiple Sclerosis Publisher Pubmed



Habibi Moini S ; Hamidi M ; Rezaei A ; Sarvestani Z ; Azizan Z ; Mohammadianinejad SE ; Harirchian MH
Source: Multiple Sclerosis and Related Disorders Published:2026

Abstract

Background: Cognitive impairment is a prevalent challenge in individuals with multiple sclerosis (MS). Cognitive reserve (CR), a multifaceted concept has been shown to have a protective role against cognitive decline. This study explores the association between cognitive reserve as measured by Cognitive Reserve Index questionnaire (CRIq), cognitive scores, and patients’ characteristics in MS patients. Additionally, we compared the predictive value of CR in cognitive function when measured by education alone versus the CRIq to examine the advantages of latter model. Materials and methods: A total of 81 patients (39.22 ± 8.09 years old, 64 female) were recruited for the study and completed the interview. Cognitive function was evaluated with the “Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). CRIq and depression questionnaires were also obtained. Results: CRIq score had significant correlation with all three age-adjusted cognitive test scores (rho = 0.551, 0.392, 0.418 for information processing speed, verbal memory and visuospatial memory respectively, p < 0.001 for all tests). The inclusion of CRIq significantly improved the cognitive function models, accounting for an additional 10.8% to 18.7% of the explained variance beyond age, and clinical predictors. In hierarchical regression models, education did not provide significant additional predictive value beyond CRIq scores across all three cognitive tests. Conclusions: The CRIq provides a more comprehensive measure of CR than formal education alone, underscoring the multidimensional nature of cognitive enrichment in adults. © 2026