Abstract Details

Title Timing is Everything: Comorbid Conditions Diagnosed after Multiple Sclerosis have Greater Effect on Disability, Participation and Quality of Life Among Older People with Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-020

Objective We aimed to determine the prevalence and impact of comorbidities on disability, participation and health related quality of life (HRQoL) in older individuals living with MS.

Background Aging with MS coincides with higher risk of comorbid conditions. However, the prevalence and impact of comorbid conditions among older individuals with MS is unknown.

Design/Methods

Participants were 743 Canadians older than 55 years with MS symptoms >20 years and completed a national postal survey. The MS co-morbidity index was used to determine types of comorbidities and year of diagnosis. Barthel Index and the Frenchay Activities Index measured disability and participation, respectively. HRQoL was measured using a visual analogue scale. Prevalence of conditions were compared to estimates in the MS population reported by Marrie et al. (2015). Hierarchical linear regressions predicted impact of comorbidities on disability, participation and HRQoL controlling for type of MS and years with MS.

Results 85.2% of the sample reported at least one comorbid condition, with 2.54 (±2.09) average conditions per person. The most prevalent conditions were hypertension (35.7%), dyslipidemia (26.6%) and depression (25.7%) with comparable prevalence to younger groups with MS. Overall, MS-related factors combined with comorbid conditions had significant but low predictive value; disability (R²=12%), participation (R²=13%) and HRQoL (R²=5%). Timing of comorbid condition diagnosis was important. For every year following MS diagnosis, diagnosis of a mental health or autoimmune comorbidity predicted decreased HRQoL (β= -0.34, p<0.03). Each year following MS diagnosis, diagnosis of diabetes predicted decreased participation (β= -0.14, p=0.04). Paradoxically, diagnosis or arthritis or fibromyalgia showed a protective effect on disability (β=5.02; p<0.01) and participation (β=2.09, p<0.01).

Conclusions Rates of comorbidity are similar to that reported in younger people with MS with cardiovascular conditions and depression as the most prevalent. The impact of diagnosis of a co-morbid condition is greater when it occurs after MS diagnosis.

Authors/Disclosures
Megan C. Kirkland PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file

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