Fardowsa LA Yusuf1, José Ma Wijnands2, Elaine Kingwell2, Feng Zhu2, Charity Evans3, John D Fisk4, Yinshan Zhao5, Jason M Sutherland6, David M Patrick7, Ruth Ann Marrie8, Helen Tremlett2. 1. UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 2. UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada. 3. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada. 4. Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, Canada. 5. UBC Hospital, Division of Neurology, Faculty of Medicine and The Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada/BC Centre for Improved Cardiovascular Health, Vancouver, BC, Canada. 6. Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 7. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 8. Departments of Internal Medicine and Community Health Sciences, Health Sciences Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Abstract
BACKGROUND: There is increasing evidence of prodromal multiple sclerosis (MS). OBJECTIVE: The aim of this study was to determine whether fatigue, sleep disorders, anaemia or pain form part of the MS prodrome. METHODS: This population-based matched cohort study used linked administrative and clinical databases in British Columbia, Canada. The odds of fatigue, sleep disorders, anaemia and pain in the 5 years preceding the MS cases' first demyelinating claim or MS symptom onset were compared with general population controls. The frequencies of physician visits for these conditions were also compared. Modifying effects of age and sex were evaluated. RESULTS: MS cases/controls were assessed before the first demyelinating event (6863/31,865) or MS symptom onset (966/4534). Fatigue (adj.OR: 3.37; 95% CI: 2.76-4.10), sleep disorders (adj.OR: 2.61; 95% CI: 2.34-2.91), anaemia (adj.OR: 1.53; 95% CI: 1.32-1.78) and pain (adj.OR: 2.15; 95% CI: 2.03-2.27) during the 5 years preceding the first demyelinating event were more frequent among cases, and physician visits increased for cases relative to controls. The association between MS and anaemia was greater for men; that between MS and pain increased with age. Pre-MS symptom onset, sleep disorders (adj.OR: 1.72; 95% CI: 1.12-2.56) and pain (adj.OR: 1.53; 95% CI: 1.32-1.76) were more prevalent among cases. CONCLUSION: Fatigue, sleep disorders, anaemia and pain were elevated before the recognition of MS. The relative anaemia burden was higher in men and pain more evident among older adults.
BACKGROUND: There is increasing evidence of prodromal multiple sclerosis (MS). OBJECTIVE: The aim of this study was to determine whether fatigue, sleep disorders, anaemia or pain form part of the MS prodrome. METHODS: This population-based matched cohort study used linked administrative and clinical databases in British Columbia, Canada. The odds of fatigue, sleep disorders, anaemia and pain in the 5 years preceding the MS cases' first demyelinating claim or MS symptom onset were compared with general population controls. The frequencies of physician visits for these conditions were also compared. Modifying effects of age and sex were evaluated. RESULTS: MS cases/controls were assessed before the first demyelinating event (6863/31,865) or MS symptom onset (966/4534). Fatigue (adj.OR: 3.37; 95% CI: 2.76-4.10), sleep disorders (adj.OR: 2.61; 95% CI: 2.34-2.91), anaemia (adj.OR: 1.53; 95% CI: 1.32-1.78) and pain (adj.OR: 2.15; 95% CI: 2.03-2.27) during the 5 years preceding the first demyelinating event were more frequent among cases, and physician visits increased for cases relative to controls. The association between MS and anaemia was greater for men; that between MS and pain increased with age. Pre-MS symptom onset, sleep disorders (adj.OR: 1.72; 95% CI: 1.12-2.56) and pain (adj.OR: 1.53; 95% CI: 1.32-1.76) were more prevalent among cases. CONCLUSION:Fatigue, sleep disorders, anaemia and pain were elevated before the recognition of MS. The relative anaemia burden was higher in men and pain more evident among older adults.
Entities:
Keywords:
Multiple sclerosis; health care utilization; population-based data; prodrome
Authors: Daniel Jons; Henrik Zetterberg; Martin Biström; Lucia Alonso-Magdalena; Martin Gunnarsson; Magnus Vrethem; Kaj Blennow; Staffan Nilsson; Peter Sundström; Oluf Andersen Journal: Ann Clin Transl Neurol Date: 2022-05-03 Impact factor: 5.430
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