A cross-sectional study investigating age of multiple sclerosis onset and its association with self-management...

Self-management knowledge and behaviors may develop differently depending on age of multiple sclerosis (MS) onset.

1) Are age of MS onset and self-management associated? 2) Does age of MS onset modify the relationship between self-management and clinically important outcomes?

Adult participants from the Canadian Prospective Cohort Study to Understand Progression in MS, completed the Multiple Sclerosis Self-Management Scale-2 (MSSM-2). We tested the relationship between age of onset and MSSM-2 scores using multivariable linear regression, adjusting for age and sex. We also tested if age of onset modifies the relationship between MSSM-2 and anxiety (Generalized Anxiety Disorder-7 (GAD-7)), depression (Patient Health Questionnaire-9 (PHQ-9)), fatigue (Modified Fatigue Impact Scale (MFIS)), and health related quality of life (HrQoL, MS Quality of Life-54).

This analysis included 104 participants, mostly female (76.9 %, n = 80), with a mean age of 38.8 years (SD=10.5), and age of onset of 10-58 years (mean=31.2, SD=11.0). We found no evidence of a relationship between age of onset and MSSM-2 (β= -0.15, p = 0.637). Worse anxiety, depression, and fatigue were associated with worse self-management; better HrQoL was associated with better self-management (PHQ-9: β= -1.06, p = 0.001, GAD-7: β= -0.53, p = 0.041, MFIS: β= -0.17, p = 0.008, Physical HrQoL: β= 0.20, p = 0.003, Mental HrQoL: β= 0.26, p < 0.001). Age of onset did not modify these relationships.

Age of MS onset was not associated with self-management. Better self-management associated with less anxiety, depression, and fatigue, and higher HrQoL. Clinicians should assess mood, fatigue, and quality of life to understand self-management in MS.