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Disability progression in multiple sclerosis: a latent class analysis of predictors
Jie Guo1, Tomas Olsson2, Lars Alfredsson3,4
1Department of Nutrition and Health, China Agricultural University, Beijing, China.
Journal of Neurology
|February 20, 2026
Summary
Multiple sclerosis (MS) progression varies greatly. Early clinical and lifestyle factors like obesity and smoking predict disability, while physical activity may improve outcomes, aiding personalized MS care.
Area of Science:
- Neurology
- Epidemiology
- Biostatistics
Background:
- Multiple sclerosis (MS) is characterized by heterogeneous disability progression.
- Predicting long-term outcomes in MS remains challenging for clinical decision-making.
Purpose of the Study:
- To identify distinct patterns of disability progression in relapsing-onset MS.
- To determine early clinical and lifestyle factors associated with these progression trajectories.
Main Methods:
- Latent class trajectory modeling applied to Expanded Disability Status Scale (EDSS) data from 3163 MS patients.
- Analysis of baseline demographics, clinical data, and lifestyle factors.
- Multivariate logistic regression and Kaplan-Meier analyses.
Main Results:
- Seven distinct EDSS trajectories were identified, with most patients showing stable low disability.
- Unfavorable progression trajectories were associated with older age at diagnosis, longer disease duration, higher baseline EDSS, frequent relapses, cognitive impairment, and autoimmune comorbidities.
- Obesity, smoking, and low sun exposure predicted worse outcomes, while physical activity was protective. Vitamin D levels showed no significant association.
Conclusions:
- Early clinical characteristics and lifestyle choices significantly influence long-term multiple sclerosis progression.
- Identifying these factors early can improve risk stratification and inform personalized management strategies for MS patients.
