Socioeconomic status and disability progression in multiple sclerosis: A multinational study

Neurology
Katharine E HardingHelen Tremlett

Abstract

To examine the association between socioeconomic status (SES) and disability outcomes and progression in multiple sclerosis (MS). Health administrative and MS clinical data were linked for 2 cohorts of patients with MS in British Columbia (Canada) and South East Wales (UK). SES was measured at MS symptom onset (±3 years) based on neighborhood-level average income. The association between SES at MS onset and sustained and confirmed Expanded Disability Status Scale (EDSS) 6.0 and 4.0 and onset of secondary progression of MS (SPMS) were assessed using Cox proportional hazards models. EDSS scores were also examined via linear regression, using generalized estimating equations (GEE) with an exchangeable working correlation. Models were adjusted for onset age, sex, initial disease course, and disease-modifying drug exposure. Random effect models (meta-analysis) were used to combine results from the 2 cohorts. A total of 3,113 patients with MS were included (2,069 from Canada; 1,044 from Wales). A higher SES was associated with a lower hazard of reaching EDSS 6.0 (adjusted hazard ratio [aHR] 0.90, 95% confidence interval [CI] 0.89-0.91), EDSS 4.0 (aHR 0.93, 0.88-0.98), and SPMS (aHR 0.94, 0.88-0.99). The direction of findings was simi...Continue Reading

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Citations

Jan 15, 2020·Multiple Sclerosis : Clinical and Laboratory Research·Amber SalterRuth Ann Marrie
Aug 31, 2019·Multiple Sclerosis : Clinical and Laboratory Research·Rachel BrandstadterJames F Sumowski
Nov 16, 2019·Journal of Neurology, Neurosurgery, and Psychiatry·Thor Ameri ChalmerMelinda Magyari
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Nov 21, 2020·Multiple Sclerosis and Related Disorders·Negar MolazadehMohammad Ali Sahraian
Jan 27, 2020·Multiple Sclerosis and Related Disorders·Floriane CalocerGilles Defer
May 3, 2021·Multiple Sclerosis and Related Disorders·Enrique Gómez-FigueroaJosé Flores-Rivera
Jun 11, 2021·Multiple Sclerosis and Related Disorders·Heidi Øyen FlemmenElisabeth Gulowsen Celius
Jul 5, 2021·Multiple Sclerosis and Related Disorders·Vladimira TimkovaIveta Nagyova
Aug 20, 2021·Neurological Research·Hayder K HassounZuhair Allebban
Sep 5, 2021·Journal of Neurology·Ivo BozovicIvana Basta
Nov 1, 2021·Brain : a Journal of Neurology·Eleni S VasileiouKathryn C Fitzgerald

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