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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Comorbidity in multiple sclerosis: implications for patient care
1Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, 820 Sherbrook Street, Winnipeg Manitoba R3A 1R9, Canada.
Abstract:
Most efforts aimed at understanding the notable heterogeneity of outcomes in multiple sclerosis (MS) have focused on disease-specific factors, such as symptoms at initial presentation, initial relapse rate, and age at symptom onset. These factors, however, explain relatively little of the heterogeneity of disease outcomes. Owing to the high prevalence of comorbidity in MS and the potential for its prevention or treatment, comorbidity is of rising interest as a factor that could explain the heterogeneity of outcomes. A rapidly growing body of evidence suggests that comorbidity adversely affects outcomes throughout the disease course in MS, including diagnostic delays from symptom onset, disability at diagnosis and subsequent progression, cognition, mortality, and health-related quality of life. Therefore, clinicians need to incorporate the prevention and management of comorbidity when treating patients with MS, but managing comorbidities in MS successfully may require the adoption of new collaborative models of care.
Insights
Comorbidity significantly impacts multiple sclerosis (MS) outcomes, affecting diagnosis, disability, cognition, and quality of life. Managing these co-existing conditions is crucial for better patient care in MS.
Area of Science:
- Neurology
- Clinical Medicine
- Epidemiology
Background:
- Multiple sclerosis (MS) exhibits significant outcome heterogeneity.
- Disease-specific factors explain limited outcome variability in MS.
- Comorbidity is increasingly recognized as a key factor influencing MS outcomes.
Purpose of the Study:
- To investigate the impact of comorbidity on multiple sclerosis (MS) disease outcomes.
- To highlight the role of comorbidity in explaining MS outcome heterogeneity.
Main Methods:
- Review of existing evidence on comorbidity in multiple sclerosis.
- Analysis of studies examining the relationship between comorbidity and MS outcomes.
Main Results:
- Comorbidity adversely affects diagnostic delays, disability progression, cognition, and quality of life in MS patients.
- Evidence suggests comorbidity influences mortality in individuals with MS.
Conclusions:
- Comorbidity plays a critical role in the heterogeneity of multiple sclerosis outcomes.
- Effective management of MS requires integrated prevention and treatment of comorbidities.
- Collaborative care models may be necessary for successful comorbidity management in MS.
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