Image from MSARDs As the entire world learns to embrace ageing, it brings with challenges for healthcare service delivery and economy. Although, MS is a disease of the young (median age of onset is 32) ageing looms in the horizon and cannot be blithely ignored. In some instances, the MS isn’t picked up until much later (the oldest patient I’ve diagnosed is 84 years old!), which raises...
#ClinicSpeak: a double-whammy
If you thought having MS was bad enough the Swedish study below confirms that people with MS are more likely to have a raft of other diseases, which include cardiovascular disease (CVD), stroke, heart failure, venous thromboembolism, other autoimmune conditions, bowel dysfunction, depression and fractures. These results replicate what we see from other studies and are not dissimilar what we see...
#T4TD vascular comorbidities
Did you know if you have MS and vascular comorbidity you are likely to need a walking stick approximately 6 years earlier than if you did not have vascular comorbidity? Importantly this 6-year difference in reaching EDSS 6.0 (requiring a walking stick) is larger than the treatment effect of a platform DMT. As vascular comorbidities are largely preventable are you doing anything to prevent or...
How healthy is your lifestyle?
Barts-MS rose-tinted-odometer ★★★★★ It is a no-brainer. A healthy lifestyle is one of the most effective preventive health interventions available. The study below shows that you can increase your chances, by a factor of over 20, of a life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 by making ensuring you maintain 4 or 5 low-risk lifestyle factors; i.e. not...
Do you have high blood pressure?
Barts-MS rose-tinted-odometer ★ ★ ★ ★ ★ Who knows their current blood pressure? If you have MS you should know your blood pressure, your BMI (body mass index), your lipid status and whether or not you have impaired glucose tolerance or diabetes. In other words, all pwMS should have an annual health check outside of their MS clinic appointment to be screened for comorbidities. We know that pwMS...
What’s your excuse?
What will it take to get me to stop smoking? If you are a smoker and continue to smoke you need to think about how you want to manage your own MS. We debate endlessly about the lack of progress in developing effective treatments to slow down the worsening of MS and ignore the obvious. The first study below implies that by simply stopping smoking it will have a major impact on the outcome of your...
What is end-organ damage?
Help! How do I manage progressive brain atrophy in a patient who is NEDA-3? End-organ damage is a catch-all phrase for the degeneration of the brain; it occurs as part of the ageing process that some consider pathological and others as a normal fact of life. I have hinted that I consider it both because end-organ damage is potentially modifiable via lifestyle modifications and pharmacological...