Bone Health in MSers is reduced

Huang Z, Qi Y, Du S, Chen G, Yan W. Bone mineral density levels in adults with multiple sclerosis: A meta-analysis. Int J Neurosci. 2014 Nov 18:1-21. [Epub ahead of print]

Introduction: Multiple sclerosis (MS) and osteoporosis (OP) affect a substantial proportion of the population. Accumulating evidence suggests that MS patients are at high risk for OP. We performed a meta-analysis to identify risk factors for lowered bone mineral density (BMD) in MS patients. Methods: We searched for articles within the Medline, Embase and Cochrane Library databases, published up to March 2014, pertaining to associations between MS and BMD. A total of 11 studies was included in the meta-analysis. Results: The analysis indicated that MS patients have reduced lumbar spine, femur neck and hip BMD compared with healthy controls (lumbar spine, standardized mean difference (SMD) = -0.76, 95% CI: -1.07, -0.45; femur neck, SMD = -0.56, 95% CI: -0.84, -0.29; and hip, SMD = -0.62, 95% CI: -0.96, -0.29). Further subgroup analysis revealed that a disease duration of > 7 years, total steroid dose during the disease of > 15 g, and an Expanded Disability Status Scale (EDSS) score of > 3, increased the risk of reduced BMD in the lumbar spine and femoral neck, but not in the hip. Meta-regression analysis did not explain the heterogeneity in the clinical characteristics or outcome definitions. Conclusions: Our meta-analysis suggests that MS patients have reduced overall BMD compared with healthy controls. Furthermore, disease duration (> 7 years), total steroid dose (> 15 g) and EDSS score (> 3) are risk factors for reduced BMD in MS patients

You know this already..make sure you maintain good bone health

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  • It is known that load bearing exercise helps with maintaining/improving bone density, so one of the questions that comes to my mind is about the capacity of MSers who have a level of disability to undertake such exercise, and the consequent impacts over time of this on bone density. That is – MS fatigue + MS muscle weakness + MS lack of coordination can make maintaining or undertaking adequate exercise more than a bit of a problem – for me my own individual combination of these three means that any exercise or effort involving sustained physical activity is extremely difficult.

    I wonder if any of the studies used in this analysis factored this problem (i.e. exercise levels and capacity to undertake exercise) into the data that produced their final conclusions. I suspect not………..

    I think this exercise problem just reinforces the need to ensure a multi-disciplinary approach to treating the whole MS person, not just the things that can be measured with clinical tests.

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