TY - JOUR
T1 - Socioeconomic status and race are correlated with affective symptoms in multiple sclerosis
AU - Wang, Yujie
AU - Tian, Fan
AU - Fitzgerald, Kathryn C.
AU - Bhattarai, Jagriti “Jackie”
AU - Naismith, Robert T.
AU - Hyland, Megan
AU - Calabresi, Peter A.
AU - Mowry, Ellen M.
N1 - Funding Information:
This study utilized data available from the Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) network, which is a network of seven MS centers in the US and three in Europe, comprised of patients with confirmed clinically isolated syndrome (CIS) or MS, and is supported by Biogen. US centers were exclusively included in this study since the social implications of race likely differ dramatically between countries. The US centers include the Cleveland Clinic, Cleveland Clinic Nevada, New York University, Ohio Health Research Institute, Johns Hopkins University, University of Rochester, and Washington University in St. Louis. Data are collected using an iPad-based system during participants’ routine clinical care activities at each center. Participants enter demographic characteristics including age, sex, ethnicity, race (American Indian/Alaska Native, Asian, Black or African American [AA], Native Hawaiian/Other Pacific Islander, White or Caucasian American [CA]), as well as MS characteristics including age at symptom onset, disease subtype, and disease modifying therapy (DMT) use. Clinical and lifestyle information, including height and weight (used to calculate body mass index [BMI]) and smoking status, is also available. Participants complete the MS Performance Test (MSPT), which is an iPad-based adaptation of the MS Functional Composite (MSFC) and includes assessment of walking speed, manual dexterity, vision, and processing speed, in addition to a health questionnaire and the Neuro-QoL (see details of the latter below). (Rudick et al., 2014)Study funding: The MS PATHS study is funded by Biogen. Biogen did not have a role in this analysis.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/6
Y1 - 2020/6
N2 - Objective: Investigate the relationship between socioeconomic status (SES) and race with self-reported fatigue, depression, and anxiety levels in multiple sclerosis (MS). Methods: Cross-sectional review of the MS Partners Advancing Technology and Health Solutions (MS PATHS) database for adults with MS in the United States. We evaluated race and socioeconomic status (available markers: insurance, employment status, or level of education) as predictors of fatigue, depression, and anxiety sub-scores of the Neuro-QoL (Quality of life in neurological disorders), with particular interest between Caucasians/whites (CA) and African Americans/blacks (AA). Multivariate linear regression models included as covariates age, sex, disability status, smoking status, body mass index, and disease-modifying therapy. Results: 7,430 individuals were included; compared to CA, AA tended to be younger, more female-predominant, and had a higher level of disability. AA had completed slightly less education, had a higher level of Medicaid coverage or uninsured status, and had higher rates of unemployed or disabled status. In the univariate model, markers of lower SES, by whichever definition we used, correlated with worse affective symptoms. In the multivariate model stratified by race, CA showed similar trends. In contrast, in AA, only lower SES by employment status was correlated with worse affective symptoms. In both CA and AA, moderate and severe level of disability correlated with worse affective symptoms. Conclusion: SES and race may influence affective symptoms reported by individuals with MS. The reasons for the correlation are likely multifactorial. Longitudinal studies should strive to identify factors associated with risk of affective symptoms in MS that may be modifiable.
AB - Objective: Investigate the relationship between socioeconomic status (SES) and race with self-reported fatigue, depression, and anxiety levels in multiple sclerosis (MS). Methods: Cross-sectional review of the MS Partners Advancing Technology and Health Solutions (MS PATHS) database for adults with MS in the United States. We evaluated race and socioeconomic status (available markers: insurance, employment status, or level of education) as predictors of fatigue, depression, and anxiety sub-scores of the Neuro-QoL (Quality of life in neurological disorders), with particular interest between Caucasians/whites (CA) and African Americans/blacks (AA). Multivariate linear regression models included as covariates age, sex, disability status, smoking status, body mass index, and disease-modifying therapy. Results: 7,430 individuals were included; compared to CA, AA tended to be younger, more female-predominant, and had a higher level of disability. AA had completed slightly less education, had a higher level of Medicaid coverage or uninsured status, and had higher rates of unemployed or disabled status. In the univariate model, markers of lower SES, by whichever definition we used, correlated with worse affective symptoms. In the multivariate model stratified by race, CA showed similar trends. In contrast, in AA, only lower SES by employment status was correlated with worse affective symptoms. In both CA and AA, moderate and severe level of disability correlated with worse affective symptoms. Conclusion: SES and race may influence affective symptoms reported by individuals with MS. The reasons for the correlation are likely multifactorial. Longitudinal studies should strive to identify factors associated with risk of affective symptoms in MS that may be modifiable.
KW - Epidemiology
KW - Health outcomes
KW - Multiple sclerosis
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85079879511&partnerID=8YFLogxK
U2 - 10.1016/j.msard.2020.102010
DO - 10.1016/j.msard.2020.102010
M3 - Article
C2 - 32088654
AN - SCOPUS:85079879511
SN - 2211-0348
VL - 41
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
M1 - 102010
ER -