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The following is a summary of “Education moderates the association between motor involvement and executive status in ALS,” published in the December 2024 issue of Neurology by Aiello et al.    

Educational attainment, a standard proxy for cognitive reserve, may influence the relationship between motor function and cognitive/behavioral outcomes in people with amyotrophic lateral sclerosis (ALS) without dementia.  

Researchers conducted a retrospective study to examine whether educational attainment influences the association between motor and cognitive outcomes in people with ALS who do not have dementia.  

They assessed 726 people with ALS who did not have frontotemporal dementia (FTD) for motor function (ALS Functional Rating Scale-Revised [ALSFRS-R]), cognitive function (Edinburgh Cognitive and Behavioral ALS Screen [ECAS]), and behavioral outcomes (ECAS-Carer Interview [ECAS-CI]). Education was measured over the years, and moderation models were used to analyze the impact of ALSFRS-R on the ECAS subscales and ECAS-CI, with education serving as the moderator.  

The results showed that education was associated with both ALSFRS-R and all cognitive subscales of the ECAS but not with ECAS-CI. A significant education^*ALSFRS-R interaction was found only for the ECAS-Executive, with higher ALSFRS-R scores linked to better ECAS-Executive scores in people with low (P<0.001) and average (P=0.007) education, but not in those with high education levels.  

They concluded that education may offer protection against cognitive and motor decline in people with ALS who do not have dementia.  

Source: onlinelibrary.wiley.com/doi/full/10.1111/ene.70027