Abstract Details

Title Preserved Cognition With Multiple Sclerosis at Age 60: Association With Sex-specific Lifespan Factors

Topic Multiple Sclerosis

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 18-008

Objective Identify predictors of preserved cognition in older adults with MS.

Background

Cognition declines with age and over the multiple sclerosis (MS) disease course, yet the predictors of preserved cognition in older people with MS are underexplored. Lifespan exposures, such as neighborhood income and reproductive factors, may contribute to cognition in this patient population.

Design/Methods Prospectively collected cognitive measures were evaluated at age 60 for 182 adults with MS participating in a longitudinal cohort study. Cognition was assessed and normalized using two cognitive tests (Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test-3 (PASAT-3)). Linear regression models were fit for clinical and sociodemographic variables for the entire cohort as well as for males and females separately. Covariates were: disease duration, presence of comorbidities, BMI, Expanded Disability Status Scale (EDSS) score, median home value in zip code, and for the female-specific model: reproductive lifespan (age menopause – age menarche).

Results In this cohort, 13% had preserved cognition by both SDMT and PASAT-3. In the entire cohort, disease duration, presence of comorbidities, and EDSS scores were significantly associated with cognition. In males only, higher cognitive scores were associated with higher median neighborhood home value (PASAT-3: beta=0.0168, p=0.011) and in females only, with a reproductive lifespan greater than 30 years (PASAT-3: beta=0.4761, p=0.042; SDMT: beta=0.528, p=0.036). In a sensitivity analysis using data from a subset of the cohort, T2 lesion volume was associated with worse cognition (PASAT-3: beta=-1.346, p=0.006; SDMT: beta=-3.759, p=0.001).

Conclusions Cognition at older ages showed sex-specific associations with neighborhood enrichment and lifetime reproductive factors. A holistic lifespan approach to understanding cognitive resilience could ultimately inform prevention and rehabilitation approaches to cognitive function in people with MS.

Authors/Disclosures
Denisse Morales-Rodriguez PRESENTER	Ms. Morales-Rodriguez has nothing to disclose.
Hannah Silverman	Ms. Silverman has nothing to disclose.
Maria Pia Campagna, PhD	Dr. Campagna has nothing to disclose.
Alyssa Nylander, MD, PhD (UCSF)	Dr. Nylander has nothing to disclose.
Amit Akula (University of California, San Francisco)	Amit Akula has nothing to disclose.
Refujia Gomez	Refujia Gomez has nothing to disclose.
Adam Santaniello	Mr. Santaniello has nothing to disclose.
Adam Renschen	Mr. Renschen has nothing to disclose.
Meagan Harms (University of California, San Francisco)	Meagan Harms has nothing to disclose.
Tiffany Cooper (University of San Francisco California)	Tiffany Cooper has nothing to disclose.
Robin R. Lincoln (University of California San Francisco)	Robin R. Lincoln has nothing to disclose.
Shane Poole (UCSF)	Shane Poole has nothing to disclose.
Roland G. Henry, PhD (University of California, San Francisco)	Dr. Henry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MEDDAY. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Henry has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi/Genzyme.
Stephen L. Hauser, MD (UCSF Weill Institute for Neurosciences)	Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NGM Bio. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BD. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pheno Therapeutics. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nurix Therapeutics. Dr. Hauser has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gilead. Dr. Hauser has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Accure. Dr. Hauser has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alector. Dr. Hauser has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hinge Therapeutics. Dr. Hauser has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Neurona. Dr. Hauser has a non-compensated relationship as a Clinical Trial/Primary Investigator with Roche that is relevant to AAN interests or activities. Dr. Hauser has a non-compensated relationship as a Clinical Trial/Primary Investigator with Novartis that is relevant to AAN interests or activities.
Bruce A. Cree, MD, PhD, MAS, FAAN (UCSF, Multiple Sclerosis Center)	The institution of Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. The institution of Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Cree has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neuron23. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Pharma. Dr. Cree has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Hexal/Sandoz. Dr. Cree has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. The institution of Dr. Cree has received research support from Genentech. The institution of Dr. Cree has received research support from Kyverna. Dr. Cree has received publishing royalties from a publication relating to health care.
Riley Bove, MD, FAAN (University of California, San Francisco)	Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme-Sanofi. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD-Serono. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cadenza. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Eli Lilly. The institution of Dr. Bove has received research support from Novartis. The institution of Dr. Bove has received research support from Roche Genentech.

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