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Change and onset-type differences in the prevalence of comorbidities in people with multiple sclerosis

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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.

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Acknowledgements

The authors would like to express their deepest gratitude for all the participants of the Australian Multiple Sclerosis Longitudinal Study for their continuous support and enthusiasm to respond to all surveys.

Funding

This study was supported by Multiple Sclerosis Research Australia.

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Authors and Affiliations

  1. Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia

    Lara Marie Pangan Lo, Bruce V. Taylor, Tania Winzenberg, Andrew J. Palmer, Leigh Blizzard & Ingrid van der Mei

  2. Centre for Health Policy School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Melbourne, VIC, 3053, Australia

    Andrew J. Palmer

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  1. Lara Marie Pangan Lo
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  2. Bruce V. Taylor
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Correspondence to Ingrid van der Mei.

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Lo, L.M.P., Taylor, B.V., Winzenberg, T. et al. Change and onset-type differences in the prevalence of comorbidities in people with multiple sclerosis. J Neurol 268, 602–612 (2021). https://doi.org/10.1007/s00415-020-10194-x

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  • DOI: https://doi.org/10.1007/s00415-020-10194-x

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