Cognitive Reserve Protects Against Depression in Multiple Sclerosis

man with hands on head on a park bench
man with hands on head on a park bench
Greater cognitive reserve may protect against depression in patients with multiple sclerosis.

Greater cognitive reserve protects against depression in patients with multiple sclerosis (MS), according to findings published in the Archives of Clinical Neuropsychology.

Researchers analyzed cross-sectional data of 54 patients (16 men and 38 women) with MS for cognitive, emotional, and social factors. This population had an average age of 52.6 years, mean disease duration of 16 years, and 16 participants were categorized as clinically depressed. Intelligence was evaluated through measures such as number of years of education, crystallized intelligence using the Shipley Institute of Living Scale, and cognitive healthy lifestyle factors using the Cognitive Health Questionnaire. Investigators calculated fixed cognitive reserve using years of education and the vocabulary score from the Shipley Institute of Living Scale. They also calculated malleable cognitive reserve using scores from the Cognitive Health Questionnaire. Finally, they evaluated disability using a modified self-reported Expanded Disability Status Scale and depression using the Beck Depression Inventory-Fast Screen.

When analyzing neurologic disability and cognitive reserve, researchers found that both low fixed cognitive reserve and low malleable cognitive reserve significantly predicted depression (P =.002 and P =.033, respectively), and neither high fixed cognitive reserve or high malleable cognitive reserve predicted depression (P =.52 and P =.518, respectively). This implies that neurological disability only effects depression in patients with low cognitive reserve.

Future studies need to analyze the disease progression of brain tissue loss, emotional dysfunction, and depressed mood and how this process is affected by cognitive reserve over time. Larger sample sizes with a more even distribution of patients with depression and a neuroanatomical index of disease would add to the magnitude of the research.

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The researchers concluded that “cognitive reserve may serve as a potential buffer against the negative emotional effects of neurological disability.”

This study was supported by the National MS Society. Please refer to reference for a complete list of authors’ disclosures.


Cadden MH, Guty ET, Arnett PA. Cognitive reserve attenuates the effect of disability on depression in multiple sclerosis. [published online August 28, 2018]. Arch Clin Neuropsychol. doi: 10.1093/arclin/acy067