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Does a modifiable risk factor score predict disability worsening in people with multiple sclerosis?


Marck, CH and Aitken, Z and Simpson JR, S and Weiland, TJ and Jelinek, GA, Does a modifiable risk factor score predict disability worsening in people with multiple sclerosis?, Multiple sclerosis journal - experimental, translational and clinical, 5, (4) pp. 1-8. ISSN 2055-2173 (2019) [Refereed Article]


Copyright Statement

Copyright 2019 The Authors. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (

DOI: doi:10.1177/2055217319881769


Background: Risk factors for chronic disease include smoking, hazardous alcohol consumption, physical inactivity, unhealthy body mass index and poor diet (SNAP factors). In multiple sclerosis (MS) SNAP factors are associated with health outcomes such as disability in cross-sectional studies, but longitudinal data are lacking.

Objective: The objective of this study was to assess whether a combined SNAP risk score predicts disability worsening.

Methods: Longitudinal self-reported data from two time-points 2.5 years apart from an international survey of 1225 people with MS were used in linear regression models adjusted for potential confounding. Disability worsening was measured using the patient-derived Multiple Sclerosis Severity Score.

Results: The majority (62%) had two or more risk factors, with insufficient fruit and vegetable intake (83%), unhealthy body mass index (42%) and physical inactivity (33%) most common. Some SNAP factors at follow-up were associated with disability at follow-up (cross-sectionally), and in addition there was some evidence that increasing risk factors was associated with disability worsening over the 2.5 year study period. Baseline SNAP score was not predictive of disability worsening at follow-up, however.

Conclusion: Known risk factors for morbidity and mortality were common and associated with disability cross-sectionally, but not prospectively. Further studies using longer time frames, objective measures and interventions may elucidate potential benefits from changes in risk factors on MS outcomes.

Item Details

Item Type:Refereed Article
Keywords:Multiple sclerosis, disability, disease progression, longitudinal cohort, prospective, risk factors
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Simpson JR, S (Dr Steve Simpson JR)
ID Code:152695
Year Published:2019
Web of Science® Times Cited:2
Deposited By:Medicine
Deposited On:2022-08-23
Last Modified:2022-09-08
Downloads:3 View Download Statistics

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