To investigate cognitive reserve as a possible moderator in the relationship between fatigue and depressive symptoms in persons with multiple sclerosis (PwMS). Fifty-three PwMS (37 female; mean age, 52.66; mean education, 14.81) completed comprehensive neuropsychological testing and psychosocial questionnaires assessing the perceived effects of fatigue (Fatigue Impact Scale) and depressive symptoms (Beck Depression Inventory-Fast Screen). Cognitive reserve (CR) was operationalized as Fixed CR and Malleable CR. Fixed CR was quantified as the standardized mean of years of education and a vocabulary-based estimate of premorbid intelligence. Malleable CR was quantified as the standardized mean of cognitive exertion, exercise, and socializing items from the Cognitive Health Questionnaire. Regressions on depressive symptoms examining fatigue, both conceptualizations of CR, and their interactions were explored. A Bonferroni correction was used; results were considered significant at an alpha level of p < .01. The interactions between fatigue and both conceptualizations of CR were significant, p = .005 (Fixed CR); p = .004 (Malleable CR). Simple effects tests revealed that fatigue only predicted depressive symptoms in PwMS with low Fixed CR or low Malleable CR (p's < .001), and not in those with high Fixed or high Malleable CR (p > .01). Cognitive reserve moderated the relationship between fatigue and depressive symptoms in PwMS. Specifically, fatigue does not appear to influence depression in PwMS with high cognitive reserve. Having higher cognitive reserve (either Fixed or Malleable) may reduce the likelihood that fatigue will lead to depressive symptoms in MS.

中文翻译：

---

认知储备可缓解多发性硬化症中疲劳和抑郁症状的影响。

调查认知储备作为多发性硬化症 (PwMS) 患者疲劳和抑郁症状之间关系的可能调节因素。53 名 PwMS（37 名女性；平均年龄 52.66；平均教育程度 14.81）完成了全面的神经心理学测试和心理社会调查问卷，评估疲劳（疲劳影响量表）和抑郁症状（贝克抑郁量表快速筛查）的感知影响。认知储备（CR）被实施为固定 CR 和可延展 CR。固定 CR 被量化为受教育年限的标准化平均值和基于词汇的病前智力估计。可塑性 CR 被量化为认知健康问卷中认知消耗、锻炼和社交项目的标准化平均值。探讨了抑郁症状的回归检查疲劳、CR 的概念及其相互作用。使用 Bonferroni 校正；在 p < .01 的 alpha 水平下，结果被认为是显着的。疲劳与 CR 的两种概念之间的相互作用非常显着，p = .005（固定 CR）；p = .004（可延展 CR）。简单效应测试显示，疲劳仅预测具有低固定 CR 或低可塑性 CR (p's < .001) 的 PwMS 的抑郁症状，而不能预测具有高固定 CR 或高可塑性 CR (p > .01) 的 PwMS 的抑郁症状。认知储备调节 PwMS 中疲劳和抑郁症状之间的关系。具体来说，疲劳似乎不会影响具有高认知储备的 PwMS 的抑郁。具有较高的认知储备（固定或可塑）可能会降低疲劳导致多发性硬化症抑郁症状的可能性。