Timing is Everything: Comorbid Conditions Diagnosed after Multiple Sclerosis have Greater Effect on Disability, Participation and Quality of Life Among Older People with Multiple Sclerosis

Lay Summary 
Introduction: People with multiple sclerosis(In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerves.) have higher rates of comorbid conditions than people their own age without MS. It is also known that the prevalence of comorbid conditions increases as people grow older. With the advent of disease-modifying therapies, people with MS are now aging longer, requiring longer-term maintenance of function and quality of life. However, we do not know the prevalence or impact of comorbid conditions in this demographic, as the first cohort of people with MS who were treated with disease-modifying therapies are only now reaching elderly age. Objective: To determine the prevalence and impact of comorbid conditions on disability, participation and health-related quality of life (HRQoL) in older individuals living with MS. Methods: Participants were 743 Canadians older than 55 years who had MS symptoms >20 years. They completed a national postal survey. They answered questions about their health conditions, function at home (disability), participation in various activities and HRQoL. Results: 85.2% of the sample reported at least one comorbid condition, with 2.54 average conditions per person. The most common conditions were hypertension (35.7%), dyslipidemia (26.6%) and depression (25.7%). Conditions such as thyroid disease (16.4%), skin/breast cancer (8.3/4.0), hip/knee replacements (4.2/2.8%), and eye conditions (cataracts 18.8%, glaucoma 4.4%) were more common in this older sample than previously reported in younger groups with MS. Having depression or anxiety had a negative effect on HRQoL, but only if diagnosed after MS diagnosis. Similarly, diabetes predicted greater disability when diagnosed after MS. Lastly, arthritis or fibromyalgia comorbidity was associated with less disability and greater participation. Conclusion: Cardiovascular conditions and depression were the most common comorbidities. The impact of comorbid conditions were greater when diagnosed after MS diagnosis. 


Faculty of Medicine
Newfoundland and Labrador
Clinical Research
Industry Sectors 
Health Care and Social Assistance
Start date 
1 Jan 2020
End date 
31 Dec 2020