[Deficiency, disability and handicap in multiple sclerosis: a population-based study in Valladolid]

Apart from impairment there is hardly any other assessment of the repercussions of multiple sclerosis (MS) in population studies.

To analyze the functional state of en epidemiological series of patients in the Valladolid health district.

A descriptive transversal study of a geographically defined population base. During a period of three months and complementing a prevalence study, were assessed, by means of the Minimal Record of Disability, impairment, disability and handicap in a series of 51 patients (33 women and 18 men) with clinically defined MS, who lived in the area on 1 March 1997.

There was a primarily progressive evolution in 21.6% of the patients, and secondarily progressive in 11.8%. Average follow-up time was 9.1 years (range 1-41) and average age of onset 27.8 years (range 14.7-51.0). The distribution of scores on the Expanded Disability Status Scale was bimodal (average and interquartile range: 3.0 (1.5-5.0). 80.4% of the patients continued to be ambulatory. 21.5% had frequent urinary incontinence or required a long-term urinary catheter. Less than 20% needed help with day to day activities. 78% of the patients complained of some degree of fatigue, and 51% had difficulties with social relationships. 59.4% of the patients had full-time jobs and 70.6% had no financial problems.

The study shows that the functional state of persons with MS is better than was thought, and that assessment of the consequences of this illness should include disability and handicap profiles.