Self-reported levels of education and disability progression in multiple sclerosis
Self-reported levels of education and disability progression in multiple sclerosis
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DOI：
10.1111/ane.12555
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发表时间：
2016-12-01
影响因子：
3.5
通讯作者：
Nagels, G.
中科院分区：
文献类型：
--
作者：
D'hooghe, M. B.;Haentjens, P.;Nagels, G.
我们研究的目的是调查社会经济指标，如教育、经济状况、就业和生活状况是否与复发性和进行性多发性硬化症(MS)的疾病进展有关。材料和方法我们在佛兰德多发性硬化症协会登记的多发性硬化症患者中进行了横断面调查，包括社会经济学指标。根据扩展残疾状态量表(EDSS)6(需要手杖)，以从MS起病到达到活动残疾里程碑的时间进行Cox比例风险回归，并根据性别、发病年龄和免疫调节治疗进行调整。结果在复发MS患者中，教育年限超过12年的受试者达到EDSS 6的风险低于报告受教育时间少于12年的受试者[发病时HR为0.68(95%可信区间0.49-0.95)；出生时HR为0.71(95%可信区间0.51-0.99)]。在进展型多发性硬化症患者中，受教育时间越长，达到EDSS 6的风险越高[发病时HR为1.25(95%可信区间0.91-1.70)；出生时心率为1.39(95%可信区间1.02-1.90)]。结论我们的研究表明，自我报告的教育水平与多发性硬化症的残疾进展有关，在复发多发性硬化症患者中，最高的教育水平是保护性的。
ObjectivesThe purpose of our study is to investigate whether socioeconomic indicators such as education, financial concerns, employment, and living status are associated with disease progression in relapsing-onset and progressive-onset Multiple Sclerosis (MS).Materials and methodsWe performed a cross-sectional survey among individuals with MS, registered by the Flemish MS society and included socioeconomic indicators. A Cox proportional hazard regression was performed with the time from MS onset and from birth to reach an ambulatory disability milestone corresponding to Expanded Disability Status Scale (EDSS) 6 (requiring a cane) as outcome measure, adjusted for gender, age at MS onset, and immunomodulatory treatment.ResultsAmong the participants with relapsing-onset MS, subjects reporting education for more than 12 years had a reduced risk of reaching EDSS 6 compared to subjects reporting education for less than 12 years [HR from onset 0.68 (95% CI 0.49-0.95); HR from birth 0.71 (95% CI 0.51-0.99)]. In progressive-onset MS, longer education was associated with an increased hazard to reach EDSS 6 [HR from onset 1.25 (95% CI 0.91-1.70); HR from birth 1.39 (95% CI 1.02-1.90)].ConclusionsOur study shows an association of self-reported levels of education with disability progression in MS, with the highest level being protective in relapsing-onset MS.