Lifestyle factors and disease-specific differences in subgroups of Swedish Myasthenia Gravis

Acta Neurol Scand. 2018 Dec;138(6):557-565. doi: 10.1111/ane.13017. Epub 2018 Oct 4.

Abstract

Purpose: To evaluate disease-specific differences between Myasthenia Gravis (MG) subgroups and compare patterns of lifestyle between MG patients and population controls.

Methods: All MG patients (n = 70) in Jönköping County, Sweden, were invited to answer a disease-specific questionnaire, containing questions about disease-specific data, lifestyle, comorbidity, and mental fatigue. The patients were clinically evaluated. Four hundred age- and gender-matched population controls were invited to answer the nondisease-specific part of the questionnaire. Disease-specific issues were compared between MG subgroups. Lifestyle-related factors and concomitant conditions were compared to the population controls.

Results: Forty MG patients and 188 population controls participated in the study. In the late-onset MG (LOMG; N = 18) subgroup, the male predominance was higher than previously reported. In the early-onset MG (EOMG; N = 17) subgroup, time to diagnosis was longer, fatigue was higher, and bulbar weakness was the dominant symptom (65%). Compared to their matched population controls, LOMG patients were more obese (OR = 13.7, P = 0.015), ate less fish (OR = 4.1, P = 0.012), tended to smoke more (OR = 4.1, P = 0.086), and tended to be employed as manual laborers more often (OR = 2.82, P = 0.083). Mental health problems and sickness benefits were more common among MG patients than in controls, and MG patients were less regularly doing focused physical activity.

Conclusions: It is important to consider disease-specific differences when tailoring the management of individual MG patients. There is a need for improved knowledge on how to apply primary and secondary prevention measures to lifestyle disorders in MG patients without risk of deterioration.

Keywords: MG subgroups; Myasthenia Gravis; early-onset MG; environmental factors; fatigue; late-onset MG; lifestyle.

MeSH terms

  • Adult
  • Female
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Myasthenia Gravis*
  • Sweden