Associations of Lifestyle, Medication, and Socio-Demographic Factors With Disability in People With Multiple Sclerosis: An International Cross-Sectional Study

PLoS One. 2016 Aug 25;11(8):e0161701. doi: 10.1371/journal.pone.0161701. eCollection 2016.

Abstract

Objective: Emerging evidence links modifiable lifestyle risk factors to disease progression in multiple sclerosis (MS). We sought further evidence around this hypothesis through detailed analysis of the association with disability of lifestyle behaviours of a large international sample of people with MS.

Materials and methods: A total of 2469 people with MS from 57 countries provided self-reported data via cross-sectional online survey on lifestyle (mostly with validated tools) and the primary outcome measure, disability (Patient Determined Disease Steps), categorised from 8 steps into 3 categories, mild, moderate and major disability. Multinomial logistic regression modelling derived relative risk ratios (RRRs) for disability categories.

Results: RRRs of having moderate vs mild disability were: diet (per 30 points on 100 point scale) 0.72 (95%CI 0.52-0.98), ever smoking 1.32 (1.06-1.65), exercise (moderate/high vs low) 0.35 (0.28-0.44), latitude (per degree from the equator) 1.02 (1.01-1.04), and number of comorbidities (2 vs none) 1.43 (1.04-1.95), (3 vs none) 1.56 (1.13-2.16). RRRs of having major vs mild disability were: exercise (moderate/high vs low) 0.07 (0.04-0.11), alcohol consumption (moderate vs low) 0.45 (0.30-0.68), plant-based omega 3 supplementation 0.39 (0.18-0.86), and disease-modifying medication use 0.45 (0.29-0.70).

Conclusions: Healthier lifestyle has strong associations with disability in our large international sample of people with MS, supporting further investigation into the role of lifestyle risk factors in MS disease progression.

MeSH terms

  • Adult
  • Age Factors
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Diet
  • Disability Evaluation
  • Exercise
  • Fatty Acids, Omega-3 / therapeutic use
  • Female
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting / epidemiology*
  • Multiple Sclerosis, Relapsing-Remitting / pathology
  • Sex Factors
  • Socioeconomic Factors
  • Vitamin D / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Fatty Acids, Omega-3
  • Vitamin D

Grant support

This work was funded by philanthropic donations from the Bloom Foundation and the Horne Family Foundation. Funders had no role in study design, data collection or analysis, decision to publish, or preparation of the manuscript.