Non-Modifiable Factors Associated with Progression to Irreversible Disability in Multiple Sclerosis Patients

Abstract

Introduction: Multiple sclerosis (MS) is the leading cause of acquired motor disability in young adults. The increase in disability follows the progression of the disease and imposes on those affected a permanent multidimensional handicap. The identification of the factors associated with the evolution towards an irreversible handicap is important for an adequate therapeutic management. Objective: Identify the non-modifiable factors associated with progression to irreversible disability in patients with MS. Material and Methods: This is a prospective collection study that was carried out in the physical medicine and rehabilitation departments of the University Hospital of Oran and the HMRU of Oran, between January 2017 and December 2019. For the main analysis, we retained an EDSS score (Expanded Disability Status Scale) for the patient if he had the same functional status during the last six months. Results/Discussion: This study included 103 MS cases, including 72 women and 31 men, with a mean age at onset of symptoms of 31.83 years and a mean EDSS of 5.12 ± 1.97. The progression of the disability assessed by the EDSS scale is related to: male gender, age at advanced onset and progressive form of MS. we did not find a correlation between the severity of the handicap and the place of birth and/or residence. Our results are unanimous in the literature for certain parameters, and the same is not true for others. Conclusion: Non-modifiable factors in MS, such as age, gender and place of birth and/or residence, are important predictors of disability and should alert the clinician to appropriate and specific management even at an early stage of the disease.