Comorbid conditions…are frequent in Multiple Sclerosis (MS) and are associated with increased hospitalizations, greater disability progression, mortality risk, and contrast-enhancing lesions on brain MRI.
—Kowalec et al4
Considering Comorbidities in Multiple Sclerosis
The Impact of Comorbidities and Lifestyle
Patient Choices and Long-Term Brain Health
For a comprehensive approach to understanding MS, it is important to consider the impact of comorbidities and lifestyle behaviors. Research has shown that multiple sclerosis comorbidities can exacerbate the disease, increasing the likelihood of relapses.1-4 Lifestyle choices can also have a major impact on the overall health of the brain.1
View references on Comorbidities/Lifestyle.
The Prevalence of Comorbidities in Multiple Sclerosis
A Common and Exacerbating Problem
A Closer Look at the Multiple Sclerosis Comorbidities
Several adverse health conditions are more prevalent in patients with MS compared with the general population.5,6
In a 2016 Canadian population-based study of 23,382 patients with MS, the most common comorbidities were5,6:
- Depression
- Hypertension
- Chronic lung disease
- Anxiety
Prevalence of Comorbidity at Diagnosis and 5 Years Earlier5,6*
*Comorbidities reported in a 2016 Canadian population-based study of patients with MS (n=23,382).5,6
Other comorbidities commonly associated with MS include rheumatoid arthritis, psoriasis, irritable bowel syndrome, thyroid diseases, and epilepsy.2,7
View references on prevalence of Comorbidities.
Our main finding was that the presence of comorbidities in patients with MS was associated with more severe MR imaging outcomes of neurodegeneration and demyelination. The tissue injury of patients with MS with comorbidities was localized to the GM and particularly to the cortex.
—Zivadinov et al2
The Impact of Multiple Sclerosis Comorbidities
An Exacerbating Factor
A Closer Look at the Clinical Consequences
In patients with MS, comorbidities can have significant clinical consequences, including2,4,7:
- Increased relapse rates
- More severe MRI outcomes (demyelination and neurodegeneration)
- Accelerated disability progression
Relapse Rates:
In a prospective observational study of MS patients (N=885), patients with ≥3 comorbidities at baseline had a 45% increased relapse rate (RR) over 2 years compared with patients with no comorbidities (adjusted RR 1.45; 95% CI: 1.00-2.08).4
45%
increase relapse rate
MRI Outcomes:
Imaging studies have shown that patients with MS who have ≥1 cardiovascular risk factor have increased lesion burden and more advanced brain atrophy.2,8
Information about More Than White Matter
Disability Progression:
In a retrospective study of 3166 patients with MS, physical disability increased with each additional comorbidity.7
Comorbidities and the Brain:
Numerous studies have shown that multiple sclerosis comorbidities can negatively impact the brain.
Information about More Than White Matter
View references on impact of Comorbidities.
…Persons with MS can benefit from cognitive rehabilitation across the range of severity of cognitive impairment and neuroplasticity can be induced by cognitive rehabilitation procedures.
—Chiaravalloti et al21
The Benefits of Lifestyle Changes
Empowering Patients to Manage Their Health
How Lifestyle Changes Can Impact Disease Activity
A comprehensive approach to health in MS includes lifestyle changes to manage comorbidities that can impact disease activity.12
View references on Lifestyle Changes.