The changing face of multiple sclerosis: Differences in gender and symtoms over a 27-year period.

TitleThe changing face of multiple sclerosis: Differences in gender and symtoms over a 27-year period.
Publication TypeJournal Article
AuthorsKraft GH, McMullen KA, Bamer AM
JournalInternational Journal of MS Care

Background: Over the past few decades, changes have occurred in the diagnosis and management of multiple sclerosis (MS). Magnetic resonance imaging is now widely used, disease-modifying therapies (DMTs) are available, understanding of MS symptoms is more sophisticated, and reports exist of possible alteration in the gender ratio. Objective: To compare possible changes in MS over several decades in a community population. Design/Methods: In 1979 we conducted a survey of people with MS in western Washington (Kraft et al.: Arch Phys Med Rehabil. 1986;67:164–168). Twenty-seven years later, we resurveyed the same region and compared the results. Results: In 1979 surveys were completed by 656 people, representing approximately 34% of the regional MS population. With increased population, the 2006 survey yielded 1241 responses. Populations in both surveys were similar; mean age (1979: 49.5 years; 2006: 50.6 years), age distribution, and years since diagnosis (1979: 12.0; 2006: 13.1) were comparable. Comparison revealed important changes in gender and reporting of symptom prevalences. In 1979 the female-to-male ratio was 2.5:1, compared with 4:1 in 2006. In 2006, with the exception of depression, all MS symptoms were reported as more prevalent (P < .001). Symptoms showing the greatest increase (>100%) were cognitive (problem solving, memory). The most prevalent symptoms in 1979 (rank order: fatigue, balance, sensory, bladder) remained the top rank-ordered symptoms in 2006. Most of the other symptoms showed a moderate (<100%) increase (rank order: spasticity, eye, pain, tremor). Conclusions: This comparison indicates that MS has become even more of a female disease, and suggests that patients may now be more aware of its symptoms. It is likely that since the availability of the first DMT in 1993 and the accompanying increased research and attention, patients have developed an increasingly sophisticated and accurate understanding of MS. This is most striking in the sphere of cognitive symptomatology, an area once thought resistant to the scourges of this disease.

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