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Etiology, effects and management of comorbidities in multiple sclerosis: recent advances
Ruth Ann Marrie1,2, John D Fisk3, Kathryn Fitzgerald4
1Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Insights
People with multiple sclerosis (MS) experience more comorbid conditions, impacting disease progression, quality of life, and healthcare costs. Integrating comorbidity management into MS care is crucial for better patient outcomes.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Multiple sclerosis (MS) frequently co-occurs with other health conditions.
- Individuals with MS show higher rates of cardiovascular and psychiatric disorders compared to the general population.
- Underrepresented minority and immigrant groups with MS face a greater burden of comorbidities.
Purpose of the Study:
- To examine the impact of comorbid conditions on the course and outcomes of multiple sclerosis.
- To highlight the effects of comorbidities on individuals, healthcare systems, and society.
- To emphasize the need for integrated comorbidity management in MS care.
Main Methods:
- Analysis of population-based studies.
- Review of existing literature on comorbidity in multiple sclerosis.
- Examination of individual and systemic effects of comorbidities.
Main Results:
- Comorbidities are linked to increased MS relapse rates, physical and cognitive decline, reduced quality of life, and higher mortality.
- Comorbidities contribute to elevated healthcare utilization, costs, and work impairment.
- Emerging evidence suggests MS influences comorbidity outcomes.
Conclusions:
- Comorbid conditions significantly worsen outcomes for individuals with multiple sclerosis.
- Effective management of comorbidities must be integrated into standard MS care protocols.
- Further research is needed to establish optimal models for integrated care.
Abstract:
Comorbid conditions commonly affect people with multiple sclerosis (MS). Population-based studies indicate that people with MS have an increased incidence of ischemic heart disease, cerebrovascular disease, peripheral vascular disease, and psychiatric disorders as compared to people without MS. People with MS from underrepresented minority and immigrant groups have higher comorbidity burdens. Comorbidities exert effects throughout the disease course, from symptom onset through diagnosis to the end of life. At the individual level, comorbidity is associated with higher relapse rates, greater physical and cognitive impairments, lower health-related quality of life, and increased mortality. At the level of the health system and society, comorbidity is associated with increased health care utilization, costs and work impairment. A nascent literature suggests that MS affects outcomes from comorbidities. Comorbidity management needs to be integrated into MS care, and this would be facilitated by determining optimal models of care.
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