Cognitive reserve and memory in temporal lobe epilepsy and caregivers: a comparative pilot study.

Abstract

This pilot study analysed differences in cognitive reserve and memory between patients with temporal lobe epilepsy (TLE) and another chronically stressed population - caregivers of patients with epilepsy - and explored the relationships between these variables. In this cross-sectional study, 40 adults (20 patients with left TLE and 20 caregivers; mean age: 48.43 ± 8.86 years) underwent a neuropsychological assessment that examined cognitive reserve proxies (i.e. years of education, total intelligence quotient, and scores in the information subtest of the Wechsler Adult Intelligence Scale) and memory. Results showed no differences between groups in cognitive reserve, but patients with TLE had poorer immediate and delayed memory (i.e. verbal and visual) (for all, p < 0.05). The group (epilepsy vs. caregiver) moderated the relationship between total intelligence quotient and immediate and delayed memory indices, and between information subtest scores and delayed memory (B = 5.40, SE = 1.93, p = 0.008, 95% CI [1.49, 9.31]), with higher cognitive reserve scores being associated with better memory functioning in patients with epilepsy (for all, p < 0.01), but not in caregivers (for all, p > 0.21). Hours of caregiving and related limitations were associated with poorer memory in caregivers (for all, p < 0.05). In conclusion, cognitive reserve was associated with memory in TLE but not in caregivers, a pattern consistent with the hypothesis that reserve contributes to compensatory processes in neurological conditions. Given the cross-sectional design and small sample size, these results should be interpreted as preliminary and exploratory.