Exploring risk factors for disability in patients with multiple sclerosis

Abstract

Background: Multiple sclerosis (MS) is a chronic relapsing-progressive disease which characterized by demyelination and glial scarring in multiple sites of the brain and spinal cord white matter. MS usually begin in young adulthood (2040 years) women 2 time more than men. Compared with other diseases, MS ranks second only behind congestive heart failure in direct all-cause medical costs, with an estimated cost of 8.528-5.244$ per patient with MS annually. Aim: This study aimed to assess disability in patients with multiple sclerosis using Expanded Disability Status Scale and to determine the risk factors. Materials and Methods: We initiated the retrospective cross-sectional analyses, using data from 27 MS patients, aged 20 to 60 years in Ulaanbaatar, Mongolia. Patients completed a questionnaire on their lifestyles and clinical information. We conducted several neurological examinations, for example, evaluating reflex changes, pyramidal sign (Babinski sign), spasticity and spastic gait. Using the Expanded Disability Status Scale (EDSS) score, neurologist quantified disability levels of MS patients in eight functional systems (pyramidal, cerebellar, brainstem, sensory, bowel and bladder, visual, cerebral and others) and assigned a functional system score in each of them. We classified MS patients into two groups based on the disability levels assessed by the EDSS mild disability score <5; and moderate to severe disability score≥5. Results: We recruited 27 MS patients whose mean age was 47.4±1.6. We classified MS patients based on disability levels using the expanded disability status scale (EDSS) scores: 11.1% mild disability and 88.9% moderate to severe disability. We found that disability levels were associated with vision and balance problems. After adjusting for age, odds ratios (OR) for disease onset age were significantly associated with EDSS scores [OR, 1,00; P< 0.001; 95% confidence interval (CI, 1.02-4.39)]; OR for treatment duration had a significant effect on the EDSS scores [OR, 1,02; P<0.01; 95% CI (1,001,17)]. Conclusion: 1. MS onset age and treatment duration were increase the risk of disability. 2. Disability levels were associated with vision and balance problems