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- Title
(REH09) The Impact of Vascular Comorbidities on Perceived Functional Impact in Persons with Multiple Sclerosis.
- Authors
Gromisch, Elizabeth S.; DelMastro, Heather M.; Neto, Lindsay O.; DeLuca, Gabriele C.; Ruiz, Jennifer A.; Turner, Aaron P.; Agresta, Thomas P.; Lo, Albert C.
- Abstract
Background: Persons with multiple sclerosis (PwMS) can have a number of comorbidities and secondary conditions, which can complicate care and negatively affect health-related quality of life. In particular, chronic vascular conditions, such as diabetes, hypertension, hyperlipidemia, and heart disease, have been associated with more rapid accumulation of irreversible disability in PwMS. However, little is known about the impact of co-occurring chronic vascular conditions on perceived functional impact in PwMS. Objectives: To examine differences between PwMS with and without vascular comorbidity with regards to their self-reported functional impact. Methods: Participants (n = 257) were randomly selected PwMS who participated in the MS Characterization of Upper Extremity Functioning (MS-CUE) study. The MS Impact Scale (MSIS-29) was used to measure perceived physical and psychological impact on daily life, while the Functional Status Index (FSI) was used to assess functional performance in 5 domains: gross mobility, hand activities, personal care, home chores, and social/role activities. Due to non-normally distributed data, Mann-Whitney U analyses were conducted to examine differences between PwMS with and without a vascular comorbidity, with effect size reported as r. Results: On average, PwMS were 48.72 ± 11.56 (0-73) years old and had MS for 12.40 ± 9.78 (1-47) years, with a median Patient-Determined Disease Steps (PDDS) score of 3 (0-7). A total of 112 of 257 (43%) PwMS had at least 1 co-occurring vascular condition, with hyperlipidemia (n = 72, 64.3%) and hypertension (n = 66, 58.9%) being the most common. PwMS with at least 1 vascular comorbidity reported higher levels of physical (r = -0.29, P < .001) and psychological impact (r = -0.16, P = .009), as well as more issues with gross mobility (r = -0.28, P < .001), hand activities (r = -0.17, P = .007), personal care (r = -0.19, P = .002), home chores (r = -0.24, P < .001), and social/role activities (r = -0.24, P < .001). Conclusions: PwMS with vascular comorbidity have worse perceived functional performance and physical and psychological well-being compared to PwMS without vascular comorbidity. These findings suggest that the presence of chronic vascular conditions in PwMS negatively affects perceived functioning, which has important implications for provision of care and quality of life for PwMS. Future work unraveling the mechanism by which vascular comorbidity influences perceived functional outcomes warrants further evaluation.
- Subjects
VASCULAR diseases; CONFERENCES &; conventions; LIFE skills; MULTIPLE sclerosis; COMORBIDITY; DISEASE complications
- Publication
International Journal of MS Care, 2020, Vol 22, Issue S2, p70
- ISSN
1537-2073
- Publication type
Article