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Tytuł:
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Determinants of quality of life in pediatric- and adult-onset multiple sclerosis.
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Autorzy:
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McKay KA; From the Departments of Clinical Neuroscience (K.A.M., A.M., T.O., J.H.) and Learning, Informatics, Management and Ethics (O.E.), Karolinska Institutet; and Centre for Molecular Medicine (K.A.M., A.M., T.O.), Karolinska University Hospital, Stockholm, Sweden. .
Ernstsson O; From the Departments of Clinical Neuroscience (K.A.M., A.M., T.O., J.H.) and Learning, Informatics, Management and Ethics (O.E.), Karolinska Institutet; and Centre for Molecular Medicine (K.A.M., A.M., T.O.), Karolinska University Hospital, Stockholm, Sweden.
Manouchehrinia A; From the Departments of Clinical Neuroscience (K.A.M., A.M., T.O., J.H.) and Learning, Informatics, Management and Ethics (O.E.), Karolinska Institutet; and Centre for Molecular Medicine (K.A.M., A.M., T.O.), Karolinska University Hospital, Stockholm, Sweden.
Olsson T; From the Departments of Clinical Neuroscience (K.A.M., A.M., T.O., J.H.) and Learning, Informatics, Management and Ethics (O.E.), Karolinska Institutet; and Centre for Molecular Medicine (K.A.M., A.M., T.O.), Karolinska University Hospital, Stockholm, Sweden.
Hillert J; From the Departments of Clinical Neuroscience (K.A.M., A.M., T.O., J.H.) and Learning, Informatics, Management and Ethics (O.E.), Karolinska Institutet; and Centre for Molecular Medicine (K.A.M., A.M., T.O.), Karolinska University Hospital, Stockholm, Sweden.
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Źródło:
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Neurology [Neurology] 2020 Mar 03; Vol. 94 (9), pp. e932-e941. Date of Electronic Publication: 2019 Nov 15.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Minneapolis.
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MeSH Terms:
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Age of Onset*
Quality of Life*
Multiple Sclerosis/*psychology
Registries/*statistics & numerical data
Adolescent ; Adult ; Disability Evaluation ; Female ; Humans ; Male ; Sweden ; Young Adult
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References:
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Grant Information:
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Canada CIHR
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Entry Date(s):
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Date Created: 20191117 Date Completed: 20200714 Latest Revision: 20201211
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Update Code:
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20240104
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PubMed Central ID:
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PMC7238943
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DOI:
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10.1212/WNL.0000000000008667
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PMID:
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31732567
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Objective: To evaluate quality of life (QoL), measured by the EQ-5D, in adults with pediatric-onset multiple sclerosis (POMS) or adult-onset multiple sclerosis (AOMS) and explore determinants of QoL in both groups.
Methods: Data were collected from the nationwide Swedish multiple sclerosis (MS) registry. Demographic characteristics, EQ-5D-3 level, Multiple Sclerosis Impact Scale (MSIS-29) score, Expanded Disability Status Scale (EDSS) score, Symbol Digit Modalities Test score, relapses, and disease-modifying therapy (DMT) exposure were collected on an approximately annual basis (2011-2019). Patients with definite MS with ≥2 EQ-5D measurements collected between ages 18 and 50 were included. The principal outcome was the EQ-5D visual analogue scale (EQ-VAS) score. Linear mixed models compared all available EQ-VAS scores between patients with POMS and patients with AOMS and determinants of EQ-VAS among patients with POMS and patients with AOMS (assessed separately).
Results: A total of 5,094 persons met inclusion criteria: 354 (6.9%) had POMS. A total of 21,357 unique EQ-5D scores were recorded. Most participants were female (70.0%) with a relapsing-onset disease course (98.1%). There was no difference in EQ-VAS scores between patients with POMS and patients with AOMS following adjustment for confounders (β-coefficient for patients with POMS vs patients with AOMS [reference]: 0.99; 95% confidence interval -0.89 to 2.87). Experiencing a relapse, severe neurologic disability (EDSS ≥6.0 vs <3.0), and higher MSIS-29 psychological score were consistently associated with lower QoL, while higher information processing efficiency and exposure to first-line DMTs were associated with higher QoL scores in both groups.
Conclusions: There were no differences in QoL between patients with POMS and patients with AOMS in adulthood. Findings provide support for a focus on reducing neurologic disability and improving psychological status as approaches to potentially improve the QoL of persons with MS.
(Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)
Comment in: Pediatr Neurol Briefs. 2020 Dec 04;34:14. (PMID: 33304088)
