[P02.127] Socioeconomic Impact of Early Mobility Impairment in Patients with Multiple Sclerosis: Results from the NARCOMS Registry

Amber Salter, Birmingham, AL, Timothy Vollmer, Aurora, CO, Ruth-Ann Marrie, Winnipeg, MB, Canada, Denise Campagnolo, Tuula Tyry, Phoenix, AZ, Gary Cutter, Birmingham, AL

OBJECTIVE: To characterize the relationship of mobility with socioeconomic status in patients with multiple sclerosis (MS) using data from the NARCOMS (North American Research Committee on Multiple Sclerosis) self-report registry. BACKGROUND: Limitations in mobility impact socioeconomic factors in patients with MS, but few studies have characterized this relationship at low levels of disability. DESIGN/METHODS: We evaluated MS patients (n=8180) who completed the fall 2006 and spring 2007 NARCOMS update surveys, which included questions on demographics and socioeconomic status (employment, health insurance, education level, annual income level, marital status, and gender). Disability level was assessed with Patient Determined Disease Steps (PDDS), a validated 9 point surrogate measure for EDDS; and mobility with the Mobility Subscale of Performance Scales where 0=no disability and 6=total disability/bedridden. We performed linear and logistic regression analyses and evaluated correlations among variables. Type I error levels of =0.01 were used to control for multiple testing. RESULTS: Patient demographics were as expected for an MS population. Mobility correlated significantly with employment (men, r=0.44; women, r=0.40); the association remained significant at PDSS levels 0 to 2. Unemployment increased the most at mobility levels 2, where unassisted walking is still maintained: from 26% in women and 15% in men with no disability to 60% in patients with mild gait disability. Household income levels were higher for married than other patients (15% vs. 57% with income < $30K). Drastic drops in household income occurred at surprisingly low disability levels. CONCLUSIONS/RELEVANCE: Reductions in socioeconomic status were associated with decreasing mobility at low levels of disability. Even minor mobility impairment experienced at otherwise low disability level appears to contribute to the loss of productivity and income. Further evaluation of these relationships, and the need to address mobility impairment early in the disease, is warranted. Supported by: NARCOMS is a project of the Consortium of Multiple Sclerosis Centers (CMSC). This study was supported by ACORDA.
Category - MS and Related Diseases - Clinical Science

Tuesday, April 28, 2009 11:30 AM

Poster Session II: Multiple Sclerosis: Outcomes and Scales I (11:30 AM-2:30 PM)