Comorbidities contribute substantially to the severity of common multiple sclerosis symptoms
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ORIGINAL COMMUNICATION
Comorbidities contribute substantially to the severity of common multiple sclerosis symptoms Lara Marie Pangan Lo1 · Bruce V. Taylor1 · Tania Winzenberg1 · Andrew J. Palmer1,2 · Leigh Blizzard1 · Ingrid van der Mei1 Received: 12 May 2020 / Revised: 24 August 2020 / Accepted: 26 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background More research is needed to understand the contribution of comorbidities to MS symptomatology. Objectives To examine the dose–response relationship between the number of comorbidities and severity of MS symptoms and to assess the relative contribution of comorbidity groups and individual comorbidities to the severity of each symptom. Methods We surveyed 1223 participants of the Australian MS Longitudinal Study for the presence of 30 comorbidities and the severity of 13 MS symptoms (0–10 scale). The associations between comorbidities and symptoms were assessed using negative binomial regression. The relative contributions of comorbidities to the severity of symptoms were assessed using general dominance analysis. Results Higher number of comorbidities was most strongly associated with a higher severity of pain and feelings of anxiety and depression (ratios of means ≥ 0.12 per comorbidity increase). Comorbidities explained between 3.7% (spasticity) and 22.0% (feelings of anxiety) of the total variance of symptom severity. Mental health and musculoskeletal disorders contributed most strongly to the severity of the most common symptoms in MS. Conclusions Our findings support that early recognition and optimal management of comorbidities, particularly of mental health and musculoskeletal disorders, could have a positive impact on the severity of symptoms of people with MS. Keywords Multiple sclerosis · Prevalence · Comorbidity · Symptoms · Musculoskeletal disorder · Mental health disorder
Introduction Multiple sclerosis (MS) affects more than 2.5 million people worldwide and is considered one of the most common disabling neurological disorders [1]. The symptomatology ranges from physical symptoms including vision loss, spasticity, bladder and bowel dysfunction, walking and balance problems, fatigue and pain to psychiatric issues like Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00415-020-10192-z) contains supplementary material, which is available to authorized users. * 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
cognitive impairments, depression and anxiety [2, 3]. Previous research showed the strong impact these symptoms have on the quality of life of people with MS [4]. However, most of these symptoms are not specific to MS and could be related to other medical conditions [5]. The majo
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