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Sex and age differences in the Multiple Sclerosis prodrome.
Fardowsa L A Yusuf1,2, José M A Wijnands1, Mohammad Ehsanul Karim2,3
1Division of Neurology, Department of Medicine, The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Frontiers in Neurology
|November 21, 2022
Summary
Healthcare utilization before multiple sclerosis (MS) onset varied by sex and age. Differences in genitourinary visits, vertigo prescriptions, and injury-related hospitalizations highlight distinct MS prodrome patterns.
Area of Science:
- Neurology
- Epidemiology
- Health Services Research
Background:
- The prodromal phase of multiple sclerosis (MS) is poorly understood, particularly regarding sex and age variations.
- Investigating healthcare utilization during the MS prodrome can reveal differences in presentation.
Purpose of the Study:
- To examine sex and age-specific differences in healthcare utilization in the five years preceding a multiple sclerosis diagnosis.
- To identify potential heterogeneity in the MS prodromal phase based on demographic factors.
Main Methods:
- A population-based matched cohort study in British Columbia, Canada, involving over 6,800 MS cases and 31,000 controls.
- Analysis of administrative and clinical data, comparing healthcare utilization (physician visits, hospitalizations, prescriptions) between MS cases and controls across different sex and age groups.
- Utilized negative binomial and modified Poisson models to assess relative rates of healthcare utilization.
Main Results:
- Males with MS showed higher rates of genitourinary visits and antivertigo prescriptions.
- Older adults (≥50 years) had more injury and infection-related hospitalizations, while younger individuals (<50 years) had more sensory and cardiovascular-related visits.
- General practitioner visits were more frequent in males and older adults, with ophthalmologist visits disproportionally higher in those under 50.
Conclusions:
- Significant sex and age-specific differences in healthcare utilization exist in the MS prodrome.
- These findings underscore the heterogeneous nature of the multiple sclerosis prodromal presentation, suggesting varied pathways to diagnosis.
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