Impact of loss of mobility on instrumental activities of daily living and socioeconomic status in patients with MS

Abstract

Objective:

To assess the effects of mobility loss on instrumental activities of daily living (IADL) and socioeconomic status in multiple sclerosis (MS) patients.

Methods:

Participants were active registrants in the North American Research Committee on Multiple Sclerosis registry completing the Fall 2006 (IADL analysis, n = 10,396) or Spring 2007 (socioeconomic analysis, n = 8180) surveys. Cross-sectional correlations and linear and logistic regression were performed using sociodemographic factors, mobility scales, and Patient Determined Disease Steps as independent variables and IADLs as the response.

Results:

Mobility loss was significantly correlated with decreased IADL scores (r = −0.74; p < 0.0001); this correlation remained significant after adjustment for covariates. Mobility loss also negatively correlated with employment (r = −0.48 for women; r = −0.50 for men, both p < 0.0001) and annual income (r = −0.29; p < 0.0001). These correlations were all significant even with mild mobility loss. The relationships derived from the regression models suggest that the effect of mobility on employment is greater than the effect of demographic variables, and a small but direct effect on annual income that is independent of effects mediated through employment. The self-reported diagnosis of MS for study inclusion and use of single-item ordinal scales for mobility and disability can potentially be criticized as study limitations, although the diagnosis and the scales were previously validated.

Conclusion:

Mobility loss independently correlated with IADL, and associated with reduced socioeconomic status in people with MS. These correlations were significant with mild mobility loss, supporting early treatment.

Key words::

• Activities of daily living
• Early treatment
• Employment
• Income
• Mobility
• Multiple sclerosis
• NARCOMS database

Transparency

Declaration of funding

This project was supported by Acorda Therapeutics, Hawthorne, NY, USA, which funded the statistical analysis and editorial support for this manuscript.

Declaration of financial/other relationships

A.S. has nothing to disclose. T.T. has disclosed that he received personal compensation for activities with EMD Serono as a scientific advisory board member. R.M. has disclosed that he has received research support from Berlex, Serono, sanofi-aventis and BioMS Technology Corporation. T.V. has disclosed that he has received personal compensation for consultant activities with, and research support from, several pharmaceutical companies including Acorda. G.C. has disclosed that he has received personal compensation for activities with the National Institutes of Health, the Multiple Sclerosis Association of America, Consortium of MS Centers, Harvard University and the University of Illinois.

Some peer reviewers receive honoraria from CMRO for their review work. The peer reviewers of this paper have disclosed that they have no relevant financial relationships.

Acknowledgements

The authors thank E. Jay Bienen, PhD, and Larry Deblinger, BA, for their editorial support in the preparation of this manuscript.

Acorda was responsible for both the design and conduct of the study. Relevant parties at Acorda were allowed the opportunity to comment on the manuscript. This project was supported in part by the Consortium of Multiple Sclerosis Centers.