Cognitive reserve in post-morbid Multiple Sclerosis: Maintenance of leisure activities might not be critical for disease progression.

Introduction: It has been largely proposed that premorbid engagement in leisure activities (LA) might have protective effects against multiple sclerosis (MS) related cognitive impairments. Yet, it is not clear whether maintaining those activities after the disease outbreak is critical for disease progression. Aim of the study: To assess (i) whether MS patients tend to disengage from LA after both disease outbreak and diagnosis, and (ii) if post-morbid LA are related to current cognitive status. Methods: 25 MS patients filled-in a LA questionnaire and underwent a neuropsychological assessment. Cognitive enrichment scores were calculated for the 5 years preceding and following the first symptom’s outbreak as well as the age of diagnosis, and were compared using Wilcoxon signed-rank tests. To test the relationship between post-morbid LA engagement and current cognitive status, Pearson’s correlations were performed between cognitive enrichment scores and performance in four cognitive tests (verbal and visual episodic learning, processing speed and working memory). Results: Wilcoxon tests did not reach significance (p < 0.05) when comparing pre and post-symptom cognitive enrichment scores, suggesting that MS patients did not show a decrease in LA following the first symptom. This was also true when considering diagnosis age rather than symptom’s outbreak. Pearson’s correlations between cognitive scores and post-morbid LA were not significant. Conclusion: These results suggest that MS patients maintain their engagements in LA following the disease outbreak. Nevertheless, there were no evidence for a link between post-morbid LA engagement and cognitive status, suggesting that continuation of activities does not affect disease progression