Demographic, Genetic, and Environmental Factors That Modify Disease Course

Marrie, Ruth Ann

doi:10.1016/j.ncl.2010.12.004

Cited by 7 publications

(6 citation statements)

References 114 publications

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“…The sociodemographic and disease variables associated with better health outcomes were younger age, female gender, current employment, higher level of education, shorter disease duration, and non-progressive type of MS. DMD use was associated with higher odds of being fatigued or depressed, which may be common side effects of DMDs (29, 30), but lower odds for inability to walk unassisted. Lifestyle factors, of special interest given their modifiable character, associated with better health outcomes were non-smoking status, moderate alcohol use (vs. low), high level of physical activity (vs. low), normal BMI, healthier diet, vitamin D supplementation, and having several support people, in line with current literature (1, 2, 7). Regular meditation was associated with increased odds for fatigue, which may be due to reverse causality as our analysis here is a cross-sectional; a trial is currently underway which may provide further insights (31).…”

Section: Discussionsupporting

confidence: 73%

“…Symptoms vary and depend on which part of the CNS is affected and include numbness, tingling, fatigue, and problems with balance and vision. Common comorbidities of MS are back pain, arthritis, anxiety, and depression (1). There is a genetic predisposition to MS, however, genetics play little role in progression, severity and presence of comorbidities, which have been closely linked to environmental and lifestyle factors (1–3).…”

Section: Introductionmentioning

confidence: 99%

“…Common comorbidities of MS are back pain, arthritis, anxiety, and depression (1). There is a genetic predisposition to MS, however, genetics play little role in progression, severity and presence of comorbidities, which have been closely linked to environmental and lifestyle factors (1–3). There is a higher prevalence of MS in developed countries compared to developing countries.…”

Section: Introductionmentioning

confidence: 99%

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International Differences in Multiple Sclerosis Health Outcomes and Associated Factors in a Cross-sectional Survey

et al. 2017

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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.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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International Differences in Multiple Sclerosis Health Outcomes and Associated Factors in a Cross-sectional Survey

et al. 2017

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“…While familial studies suggested a genetic predisposition to MS, evidence of genetic associations in MS clinical course or disease severity is lacking[ 2 ]. Data are, however, emerging linking environmental and lifestyle factors to morbidity[ 3 ], thereby presenting pivotal opportunities for secondary and tertiary prevention of MS-related fatigue.…”

Section: Introductionmentioning

confidence: 99%

Clinically Significant Fatigue: Prevalence and Associated Factors in an International Sample of Adults with Multiple Sclerosis Recruited via the Internet

et al. 2015

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BackgroundFatigue contributes a significant burden of disease for people with multiple sclerosis (PwMS). Modifiable lifestyle factors have been recognized as having a role in a range of morbidity outcomes in PwMS. There is significant potential to prevent and treat fatigue in PwMS by addressing modifiable risk factors.ObjectivesTo explore the associations between clinically significant fatigue and demographic factors, clinical factors (health-related quality of life, disability and relapse rate) and modifiable lifestyle, disease-modifying drugs (DMD) and supplement use in a large international sample of PwMS.MethodsPwMS were recruited to the study via Web 2.0 platforms and completed a comprehensive survey measuring demographic, lifestyle and clinical characteristics, including health-related quality of life, disability, and relapse rate.ResultsOf 2469 participants with confirmed MS, 2138 (86.6%) completed a validated measure of clinically significant fatigue, the Fatigue Severity Scale. Participants were predominantly female from English speaking countries, with relatively high levels of education, and due to recruitment methods may have been highly pro-active about engaging in lifestyle management and self-help. Approximately two thirds of our sample (1402/2138; 65.6% (95% CI 63.7–67.7)) screened positive for clinically significant fatigue. Bivariate associations were present between clinically significant fatigue and several demographic, clinical, lifestyle, and medication variables. After controlling for level of disability and a range of stable socio-demographic variables, we found increased odds of fatigue associated with obesity, DMD use, poor diet, and reduced odds of fatigue with exercise, fish consumption, moderate alcohol use, and supplementation with vitamin D and flaxseed oil.ConclusionThis study supports strong and significant associations between clinically significant fatigue and modifiable lifestyle factors. Longitudinal follow-up of this sample may help clarify the contribution of reverse causation to our findings. Further research is required to explore these associations including randomized controlled trials of lifestyle interventions that may alleviate fatigue.

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“… 1 The incidence of MS varies greatly with geographical distribution and migration in childhood appears to influence risk of the disease developing, suggesting an important role for non-infectious environmental determinants. 2 There is, however, no evidence of genetic associations in MS clinical course or disease severity; 3 environmental factors 4 therefore present important opportunities for secondary and tertiary prevention of MS.…”

Section: Introductionmentioning

confidence: 99%

The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis

Hadgkiss

Jelinek

Weiland

et al. 2014

Nutritional Neuroscience

132

110

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ObjectivesTo explore the association between dietary factors including fat, fruit and vegetable intake, dairy and meat consumption, and health-related quality of life (HRQOL), disability and relapse rate in a large international sample of people with multiple sclerosis (MS).MethodsParticipants with MS were recruited to the study via Web 2.0 platforms and completed a comprehensive survey measuring demographic and clinical characteristics, HRQOL, disability, relapse rate, and the Diet Habits Questionnaire (DHQ).ResultsOf 2469 participants with confirmed MS, 2087 (84.5%) provided complete data on their dietary habits (DHQ total score). Multivariate regression models demonstrated that every 10-point increase on the DHQ total score was associated with nearly a six-point and five-point increase in physical and mental HRQOL, respectively, and 30.0% reduced likelihood of a higher level of disability. After controlling for age and gender, and the other dietary covariates, ‘healthy’ consumption of fruit and vegetables and dietary fat predicted better quality of life and less likelihood of higher disability when compared to respondents with a ‘poor’ diet. For those with relapsing–remitting MS, the DHQ total significantly predicted a lower relapse rate and reduced odds of increasing disease activity, but the model fit was poor and the predicted change only marginal.DiscussionThis study supports significant associations of healthy dietary habits with better physical and mental HRQOL and a lower level of disability. Further research is urgently required to explore these associations including randomized controlled trials of dietary modification for people with MS.

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Demographic, Genetic, and Environmental Factors That Modify Disease Course

Cited by 7 publications

References 114 publications

International Differences in Multiple Sclerosis Health Outcomes and Associated Factors in a Cross-sectional Survey

International Differences in Multiple Sclerosis Health Outcomes and Associated Factors in a Cross-sectional Survey

Clinically Significant Fatigue: Prevalence and Associated Factors in an International Sample of Adults with Multiple Sclerosis Recruited via the Internet

The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis

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