“The study below using data from the Scottish Primary Care dataset shows that MSers are much more likely to have one or more comorbidities, or other diseases. The problem with this study is that it implies these other disease are independent of MS, when they are clearly not and a large number of them are manifestations of MS. For example, the list of mental health conditions includes depression, anxiety, stress related & somatoform disorders, drugs misuse, anorexia or bulimia, bipolar disorder and schizophrenia. All these disorders could be a manifestation of MS. What is interesting is that MSers are less likely to be diagnosed with coronary heart disease or hypertension. The latter comes as a surprise to me; I was under the impression that MSers were at higher risk of coronary heart disease, mainly due to the common association with smoking and obesity, both of which are commoner in MSers that the general population. I will need to check to see if this finding can be reproduced in other datasets. What this study does show is that MS is a very complex disease and has numerous associated comorbidities that all need addressing. This has resource indications and needs to be taken into account with any healthcare service development. Do you have a problem with associated diseases? Does your doctor treats them as part of your MS or does he/she treat them as being unrelated to MS?”
BACKGROUND: Comorbidity in MS is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in MSers.
METHODS: 39 comorbidities in 3826 MSers aged >=25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression.
RESULTS: MSers were more likely to have one (OR 2.44; 95%CI 2.26-2.64), two (OR 1.49; 95%CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95%CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95%CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95%CI 0.36-0.67), chronic kidney disease (OR 0.51; 95%CI 0.40-0.65), heart failure (OR 0.62; 95%CI 0.45-0.85), coronary heart disease (OR 0.64; 95%CI 0.52-0.71), and hypertension (OR 0.65; 95%CI 0.59-0.72) were significantly less common in MSers.
CONCLUSION: MSers have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation.