Frailty in ageing persons with multiple sclerosis

Mult Scler. 2021 Apr;27(4):613-620. doi: 10.1177/1352458520923945. Epub 2020 May 27.

Abstract

Background: Recent progress in multiple sclerosis (MS) management has contributed to a greater life expectancy in persons with MS. Ageing with MS comes with unique challenges and bears the potential to greatly affect quality of life and socioeconomic burden.

Objectives: To compare frailty in ageing persons with multiple sclerosis (pwMS) and controls; to correlate frailty with MS clinical characteristics.

Methods: PwMS and controls over 50 years old were recruited in a cross-sectional study. Two validated frailty measures were assessed: the frailty index and the Fried's phenotype. Several multiple linear regressions accounting for demographic and clinical characteristics were performed.

Results: Eighty pwMS (57 females, mean age 58.5 ± 6 years old) and 37 controls (24 females, mean age 61 ± 6.5 years old) were recruited. Multivariable analysis identified significantly higher frailty index in pwMS (0.21 ± 0.12 vs 0.11 ± 0.08, p < 0.0001). Similarly, according to Fried's phenotype, a significantly higher percentage of pwMS were frail compared to controls (28% vs 8%). In pwMS, frailty index was independently associated with expanded disability status scale (EDSS), comorbidities, education level and disease duration.

Conclusion: Our results suggest that frailty can be routinely assessed in pwMS. Increased frailty in MS patients suggests that, along with MS therapeutics, a tailored multidisciplinary approach of ageing pwMS is needed.

Keywords: Fried’s phenotype; Multiple sclerosis; ageing; comorbidities; frailty; quality of life.

MeSH terms

  • Aging
  • Cross-Sectional Studies
  • Female
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Humans
  • Middle Aged
  • Multiple Sclerosis*
  • Quality of Life