Comorbidity Related to Disability in Multiple Sclerosis

Diagnostic delay and increased severity of disability are more significant with increased comorbidity

THURSDAY, Oct. 30 (HealthDay News) -- Both diagnostic delay and disability at diagnosis are influenced by comorbidity among multiple sclerosis patients, and these relationships need to undergo further study, according to a study published online Oct. 29 in Neurology.

Ruth Ann Marrie, M.D., Ph.D., of the University of Manitoba in Winnipeg and colleagues examined the relationship of comorbidity with diagnostic delay and severity of disability at diagnosis among patients registered with the North American Research Committee on Multiple Sclerosis Registry. Patients were questioned regarding physical and mental comorbidities, and diagnostic delay was evaluated using multivariate Cox regression. Patients diagnosed with multiple sclerosis within two years of enrollment had disability assessed with the Patient Determined Disease Steps..

After multivariable adjustment in the 8,983 participants, the researchers found that diagnostic delay significantly increased when obesity, smoking, or physical or mental comorbidities were present. Among participants enrolled within two years of diagnosis, vascular comorbidity and obesity significantly increased the odds of moderate instead of mild disability (odds ratios 1.51 and 1.38, respectively). Similarly, musculoskeletal and mental comorbidity significantly increased the odds of severe instead of mild disability (odds ratios 1.81 and 1.62, respectively).

"Our findings suggest that practitioners treating persons with chronic diseases should not attribute new neurologic signs or symptoms to existing conditions without careful consideration, but this must be balanced against overinvestigation," the authors write.

Several of the authors report financial relationships with the pharmaceutical industry.

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