Change and onset-type differences in the prevalence of comorbidities in people with multiple sclerosis
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Change and onset‑type differences in the prevalence of comorbidities in people with multiple sclerosis Lara Marie Pangan Lo1 · Bruce V. Taylor1 · Tania Winzenberg1 · Andrew J. Palmer1,2 · Leigh Blizzard1 · Ingrid van der Mei1 Received: 5 May 2020 / Revised: 24 August 2020 / Accepted: 26 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Little is known about the change in prevalence of comorbidities during the disease course of people with multiple sclerosis (MS) and whether the prevalences vary by MS onset type. Objective To calculate the change in prevalence of comorbidities between symptom onset and the time of study, to compare the prevalences of comorbidities with those in the Australian population at the time of study and to examine onset-type differences. Methods Comorbidity data from 1518 participants of the Australian MS Longitudinal Study and Australian population comparator data (2014–2015 National Health Survey) were used. The change in prevalence between time points and prevalence ratios (PR) at the time of study (crude, age and sex adjusted, and stratified by onset type) was calculated. Results Comorbidities were common, and those with the largest increases in prevalence between MS symptom onset and the time of study were depression (+ 26.9%), anxiety (+ 23.1%), hypertension (+ 21.9%), elevated cholesterol (+ 16.3%), osteoarthritis (+ 17.1%), eye diseases (+ 11.6%), osteoporosis (+ 10.9%) and cancer (+ 10.3%). Compared to the general population and after age and sex adjustment, participants had a significantly higher prevalence for 14/19 comorbidities at the time of study. The associations were strongest for anaemia, cancer (both PR > 4.00), anxiety, depression, migraine (all PR > 3.00), psoriasis and epilepsy (both PR > 2.00). No significant differences were seen by onset type. Conclusion Comorbidities are common at MS symptom onset and increase with MS duration. Having MS may thus contribute to accrual of comorbidities. This emphasises the importance of optimal screening for and management of comorbidities in early MS and throughout the disease course. Keywords Multiple sclerosis · Comorbidity · Prevalence · Prevalence ratio · MS onset type
Introduction As there is still no known cure for multiple sclerosis (MS), current treatment mainly focuses on preventing relapses and disability progression as well as improving other health outcomes of people with MS (PwMS) [1]. However, MS-related outcomes are highly heterogeneous [2, 3]. Comorbidities, * Ingrid van der Mei [email protected] 1
Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS 7000, Australia
Centre for Health Policy School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC 3053, Australia
2
the medical conditions that co-occur with an index disease [4], may explain part of the heterogeneity of clinical outcomes in MS. Comorbidities have recently e
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