Comorbidity, socioeconomic status and multiple sclerosis

• Published in: Multiple sclerosis Vol. 14; no. 8; pp. 1091 - 1098
• Main Authors: Marrie, RA, Horwitz, R, Cutter, G, Tyry, T, Campagnolo, D, Vollmer, T
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2008; Arnold; Sage Publications Ltd
• Subjects: Adult; Age of Onset; Biological and medical sciences; Comorbidity; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Diabetes Mellitus - epidemiology; Educational Status; Female; Heart Diseases - epidemiology; Humans; Hypertension - epidemiology; Income; Insurance, Health - statistics & numerical data; Male; Medical sciences; Middle Aged; Multiple Sclerosis - epidemiology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Chronic Progressive - epidemiology; Neoplasms - epidemiology; Neurology; Registries; Social Class; United States - epidemiology; United States; epidemiology; comorbidity; socioeconomic status; multiple sclerosis; Concomitant disease; Nervous system diseases; Multiple sclerosis; Socioeconomic status; Polypathology; Central nervous system disease; Degenerative disease; Epidemiology; Inflammatory disease
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458508092263

Objective
Multiple sclerosis (MS) is associated with substantial morbidity. The impact of comorbidity on MS is unknown, but comorbidity may explain some of the unpredictable progression. Comorbidity is common in the general population, and is associated with adverse health outcomes. To begin understanding the impact of comorbidity on MS, we need to know the breadth, type, and frequencies of comorbidities among MS patients. Using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry, we aimed to describe comorbidities and their demographic predictors in MS.
Methods
In October 2006, we queried NARCOMS participants regarding physical comorbidities. Of 16,141 participants meeting the inclusion criteria, 8983 (55.7%) responded.
Results
Comorbidity was relatively common; if we considered conditions which are very likely to be accurately self-reported, then 3280 (36.7%) reported at least one physical comorbidity. The most frequently reported comorbidities were hypercholesterolemia (37%), hypertension (30%), and arthritis (16%). Associated with the risk of comorbidity were being male [females vs. males, odds ratio (OR) 0.77; 0.69–0.87]; age (age >60 years vs. age ≤44 years, OR 5.91; 4.95–7.06); race (African Americans vs. Whites, OR 1.46; 1.06–2.03); and socioeconomic status (Income <$15,000 vs. Income >$100,000, OR 1.37; 1.10–1.70).
Conclusions
Comorbidity is common in MS and similarly associated with socioeconomic status.