Abstract
Multiple sclerosis (MS) is a major cause of disability and poor quality of life (QOL). Previous studies have shown differences in MS health outcomes between countries. This study aimed to examine the associations between international regions and health outcomes in people with MS. Self-reported data were taken from the Health Outcomes and Lifestyle In a Sample of people with Multiple Sclerosis online survey collected in 2012. The 2,401 participants from 37 countries were categorized into three regions: Australasia, Europe, and North America. Differences were observed between regions in disability, physical and mental health QOL, fatigue, and depression, but most of these disappeared after adjusting for sociodemographic, disease, and lifestyle factors in multivariable regression models. However, adjusted odds for disability were higher in Europe [odds ratio (OR): 2.17, 95% confidence interval (CI): 1.28 to 3.67] and North America (OR: 1.79, 95% CI: 1.28 to 2.51) compared to Australasia. There may be other unmeasured factors that vary between regions, including differences in access and quality of healthcare services, determining disability in MS. When assessing differences in MS health outcomes, lifestyle factors and medication use should be taken into consideration.
Highlights
Multiple sclerosis (MS) is a chronic autoimmune neurological disorder involving inflammation and demyelination of the central nervous system (CNS)
Multivariable regression models for disability, physical quality of life (QOL), mental health QOL, clinically significant fatigue, and depression risk were adjusted for sociodemographic, disease, and lifestyle determinants (Tables 3 and 4)
Adjusted odds for disability were higher in Europe and North America compared to Australasia (Table 4)
Summary
Multiple sclerosis (MS) is a chronic autoimmune neurological disorder involving inflammation and demyelination of the central nervous system (CNS). MS can cause debilitating physical and mental health symptoms and often affects young people. Symptoms vary and depend on which part of the CNS is affected and include. There is a genetic predisposition to MS, genetics play little role in progression, severity and presence of comorbidities, which have been closely linked to environmental and lifestyle factors [1,2,3]. There is a higher prevalence of MS in developed countries compared to developing countries. Prevalence increases as latitude from the equator increases thought to be associated with sun exposure and vitamin D [4]. Other environmental risk factors for MS onset and progression include infections, and lifestyle factors such as smoking, stress, diet, and weight [5,6,7]
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