University of Alabama at Birmingham, Royals Public Health Building 327, 1530 3rd Avenue South, Birmingham, AL 35294-0022, USA.
Curr Med Res Opin. 2010 Feb;26(2):493-500. doi: 10.1185/03007990903500649.
To assess the effects of mobility loss on instrumental activities of daily living (IADL) and socioeconomic status in multiple sclerosis (MS) patients.
Participants were active registrants in the North American Research Committee on Multiple Sclerosis registry completing the Fall 2006 (IADL analysis, n = 10,396) or Spring 2007 (socioeconomic analysis, n = 8180) surveys. Cross-sectional correlations and linear and logistic regression were performed using sociodemographic factors, mobility scales, and Patient Determined Disease Steps as independent variables and IADLs as the response.
Mobility loss was significantly correlated with decreased IADL scores (r = -0.74; p < 0.0001); this correlation remained significant after adjustment for covariates. Mobility loss also negatively correlated with employment (r = -0.48 for women; r = -0.50 for men, both p < 0.0001) and annual income (r = -0.29; p < 0.0001). These correlations were all significant even with mild mobility loss. The relationships derived from the regression models suggest that the effect of mobility on employment is greater than the effect of demographic variables, and a small but direct effect on annual income that is independent of effects mediated through employment. The self-reported diagnosis of MS for study inclusion and use of single-item ordinal scales for mobility and disability can potentially be criticized as study limitations, although the diagnosis and the scales were previously validated.
Mobility loss independently correlated with IADL, and associated with reduced socioeconomic status in people with MS. These correlations were significant with mild mobility loss, supporting early treatment.
评估多发性硬化症（MS）患者运动能力丧失对工具性日常生活活动（IADL）和社会经济地位的影响。
参与者为北美多发性硬化症研究委员会注册患者，他们完成了 2006 年秋季（IADL 分析，n=10396）或 2007 年春季（社会经济分析，n=8180）的调查。使用社会人口统计学因素、运动能力量表和患者确定的疾病阶段作为自变量，IADL 作为因变量，进行横断面相关性分析、线性和逻辑回归分析。
运动能力丧失与 IADL 评分下降显著相关（r=-0.74；p<0.0001）；调整协变量后，这种相关性仍然显著。运动能力丧失也与就业（女性 r=-0.48；男性 r=-0.50，两者均 p<0.0001）和年收入（r=-0.29；p<0.0001）呈负相关。即使是轻微的运动能力丧失，这些相关性也都是显著的。回归模型得出的关系表明，运动能力对就业的影响大于人口统计学变量的影响，对年收入也有直接影响，这种影响独立于通过就业产生的影响。纳入研究的 MS 自我报告诊断和使用单一项目的 ordinal 量表来评估运动能力和残疾可能会受到批评，尽管这些诊断和量表已经过验证。
运动能力丧失与 IADL 独立相关，与 MS 患者的社会经济地位降低有关。即使是轻微的运动能力丧失，这些相关性也很显著，提示应尽早治疗。
