Trait Conscientiousness predicts rate of longitudinal SDMT decline in multiple sclerosis

Abstract

Background: Many people with multiple sclerosis (MS) exhibit cognitive decline over several years. Baseline differences may put people at greater risk for such decline. Objective: To characterize rates of longitudinal cognitive decline and investigate baseline clinical predictors. Methods: We report a retrospective analysis of 531 MS patients whose data were gleaned from a multi-study database, aggregated over 16 years. Linear mixed effects modeling was applied to estimate the average rate of decline on Symbol Digit Modalities Test (SDMT) performance and to predict rates of decline using baseline clinical variables. Results: Participants exhibited an average estimated decline of 0.22 SDMT raw-score points/year (95% confidence interval (CI) (−0.32, −0.12)). We observed a significant main effect of time from baseline ( t = −2.78, p = 0.006), test form ( t = 2.13, p = 0.034), disease course ( t = 2.91, p = 0.004), age ( t = −2.76, p = 0.006), sex ( t = −2.71, p = 0.007), subjective cognitive impairment ( t = −2.00, p = 0.046), premorbid verbal intelligence ( t = 5.14, p < 0.001), and trait Conscientiousness ( t = 2.69, p = 0.008). A significant interaction emerged for Conscientiousness and time from baseline ( t = 2.57, p = 0.011). Conclusion: Higher baseline trait Conscientiousness predicts slower rates of longitudinal cognitive decline in MS. This relationship, the average rate of decline, and practice effects can inform future research and clinical treatment decisions.

Two Year Progression of Working Memory Impairments In Early Relapsing-Remitting Multiple Sclerosis: Appraisal of Working Memory Profiles And Measurement Sensitivity

“…Interestingly, in our study, we did not see a commensurate reduction in performance on the SDMT, the proposed gold standard measure 27,43 that similarly places demands on visual WMem and processing speed 44,45 ; indeed all pwMS identi ed as impaired by the SDMT were also identi ed by the OM n-back. This is in line with previous studies that have similarly found that the SDMT's ability to detect cognitive deterioration within 2-3 years is poor 46,47 , with performance estimated to decrease by only .22 decrease per year 48 . This may represent a combination of practice effects and the sensitivity of the measure to subtle change.…”

Conscientiousness and deterioration in employment status in multiple sclerosis over 3 years

“…9 Recently, this trait was shown to predict deterioration in cognition and brain volume over 5 years in multiple sclerosis (MS). 10,11 Low Conscientiousness is also associated with occupational stress in MS workers. 12…”

“…9 Recently, this trait was shown to predict deterioration in cognition and brain volume over 5 years in multiple sclerosis (MS). 10,11 Low Conscientiousness is also associated with occupational stress in MS workers. 12 A limitation of cross-sectional associations between these factors and employed/disabled status is that metrics of change or potentially actionable antecedents to job loss are missed.…”

Trait Conscientiousness predicts rate of brain atrophy in multiple sclerosis

“…[3][4][5] Higher Conscientiousness also predicts slower rates of cognitive decline in PwMS. 6 To our knowledge, there is no investigation of the relationship between Conscientiousness and brain atrophy using a longitudinal study design in PwMS. Herein, we report analysis of a large retrospective cohort with multiple magnetic resonance imaging (MRI) evaluations over 15 years.…”