Measuring cognitive reserve in multiple sclerosis: A systematic review of neuropsychological questionnaires and instruments

Measuring cognitive reserve in multiple sclerosis: A systematic review of neuropsychological questionnaires and instruments

/ Vol 9-Nº 2 jul-dic 2026 /

Lucía Bacigalupe1,2; Lucía Ibarra1 y María Bárbara Eizaguirre1,2

ABSTRACT

Objective: To systematically review the instruments used to measure cognitive reserve in adults with multiple sclerosis.

Method: A systematic review was conducted following PRISMA guidelines. Studies published between 2013 and 2024 were identified through PubMed, SciELO, and Google Scholar. A total of 67 studies comprising 10,353 adults with MS met the inclusion criteria. The selected studies were analyzed according to their methodological design, sample characteristics, and the instruments used to assess cognitive reserve.

Results: Considerable heterogeneity was observed in the assessment of cognitive reserve. The most frequently used measures included questionnaires evaluating engagement in cognitively stimulating activities, particularly the Cognitive Reserve Index Questionnaire (CRIq) and related instruments, as well as word-reading tasks such as the National Adult Reading Test (NART) and the Wechsler Test of Adult Reading (WTAR). Both questionnaire-based and neuropsychological approaches were commonly used as proxy measures of cognitive reserve.

Conclusion: No single gold-standard instrument for assessing cognitive reserve in MS was identified. Current approaches rely on heterogeneous proxy measures that differ in their theoretical foundations and psychometric characteristics. Greater methodological standardization and validation of cognitive reserve measures in MS populations are needed to improve comparability across studies and support clinical application.

1 Demyelinating Diseases Working Group (CUEM). Neurology Division, Dr. J.M. Ramos Mejía Hospital., Buenos Aires, Argentina. 2 Buenos Aires University, School of Psychology, Buenos Aires, Argentina.

*Corresponding author:

Buenos Aires University, School of Psychology, Buenos Aires, Argentina.
Email: lucia.bacigalupe@hotmail.com
Phone number: 5491151067499
Address: Gral. Urquiza 609,
C1221ADC Cdad. Autónoma de
Buenos Aires, Argentina

Keywords:

cognitive reserve, multiple sclerosis, measurement instruments, neurocognitive test, questionnaires.