The Extended Disability Status Scale (EDSS), which rates the progression of multiple sclerosis (MS), found that older people with and without MS had significant disabilities. These results were published in Multiple Sclerosis and Related Disorders.
Researchers from the University of Kansas Medical Center recruited people aged 55 or over (N = 106) for this study and rated them using the EDSS. Participants had (n = 51) or not (n = 55) MS (mean age 69.29 ± 7.92 versus 70.09 ± 7.66 years; women 73% versus 54%; white 94% versus 93%; respectively ). The mean comorbidities between the two groups were 5 and 6 and the number of drugs 10 and 8, respectively.
25 patients with MS had relapsing-remitting MS, 15 had primary progressive MS and 11 secondary progressive MS. The mean time since diagnosis was 24.98 years (standard deviation) [SD]± 13.6). 28 patients received no disease-modifying therapy, 14 were taking platform-injectable drugs, and 7 were taking oral drugs.
The EDSS correctly identified MS among participants 86% of the time. The mean EDSS values were 6 (interquartile range) [IQR], 3) in people with MS and 3 (IQR, 1.5) in people without MS. 18 (32.7%) participants without MS had an EDSS of 4.0 or higher.
Among the participants without MS, the total values differed significantly from 0 (P <0.001) and were significant with functional status systems of bowel / bladder (rs, 0.62; P <0.001), ambulation (rs, 0.46; P < ) associated 0.001), brainstem (rs, 0.43; P = 0.001) and pyramidal (rs, 0.40; P = 0.003), but not with visual (rs, 0.31; P = 0.02) or cerebral (rs, 0.24; P. = 0.07). The total scores were significantly higher in MS patients than in the other participants (P <0.001) and remained significantly higher after correcting the cofactors (P <0.001). Their scores were higher for all functional status systems (P. <.01) except sensory (P >.1).
In participants with and without MS, increased disability was associated with age (P = 0.001 versus P <0.001). Among those without MS, higher comorbidities (rs, 0.38; P = 0.005) were associated with higher EDSS scores. Finally, greater comorbidities were associated with the number of drugs in MS patients (rs 0.49; P <0.001).
This study was limited due to its small sample size and may not have had an opportunity to significantly identify differences between cohorts.
“These results suggest that some of the EDSS scores are due to factors other than MS. Our understanding of disease progression and disability can benefit from developing normative EDSS scores to correct for these factors, ”said the study’s researchers.
Disclosure: Several authors have stated that they are part of the pharmaceutical industry. For a full list of the details, see the original article.
Lynch S., Baker S., Nashatizadeh M. et al. Measuring Disability in Multiple Sclerosis Patients 55+: What Does the Expanded Disability Status Scale Really Tell Doctors? Mult Scler Relat Disord. Published online on December 28, 2020. doi: 10.1016 / j.msard.2020.102724