Nurs Res. 2023;72(4):281-291. doi: 10.1097/NNR.0000000000000656.
A gap in research about the trajectories of function among men and women aging with functional limitations because of multiple sclerosis (MS) hinders ability to plan for future needs.
Using a biopsychosocial model, we characterize how men and women with MS report changes over time in their function and test how person-level differences in age, diagnosis duration, and sex influence perceived function.
A longitudinal study with multiple waves of surveys was used to collect data on participant perceptions of function, as well as demographic and contextual variables. Self-reported functional limitation was measured over a decade. The study participants were community residing with physician-diagnosed MS.
The people with MS had a diagnosis duration of about 13 years and were around 51 years of age, on average, at the start of the study. They were primarily women and non-Hispanic White. We analyzed the data using mixed-effects models. Subject-specific, functional limitation trajectories were described best with a quadratic growth model. Relative to men, women reported lower functional limitation and greater between-person variation and rates of acceleration in functional limitation scores.
Results suggest function progressed through two pathways for over a decade, particularly closer to diagnoses. Variability in trajectories between individuals based on sex and years since diagnosis of disease indicates that men and women with MS may experience perceptions of their function with age differently. This has implications for clinician advice to men and women with MS.
由于多发性硬化症 (MS) 导致功能受限而导致的男性和女性衰老过程中功能轨迹的研究存在差距，这阻碍了对未来需求的规划。
我们使用生物心理社会模型来描述男性和女性多发性硬化症患者随着时间的推移报告其功能变化的情况，并检验年龄、诊断持续时间和性别等个体差异如何影响感知功能。
采用纵向研究设计，进行多次问卷调查，收集参与者对功能的感知以及人口统计学和环境变量的数据。自我报告的功能限制在十年内进行测量。研究参与者居住在社区中，且被医生诊断患有 MS。
多发性硬化症患者的诊断持续时间约为 13 年，在研究开始时的平均年龄约为 51 岁。他们主要是女性和非西班牙裔白人。我们使用混合效应模型分析数据。使用二次增长模型可以最好地描述个体特异性的功能限制轨迹。与男性相比，女性报告的功能限制较低，个体之间的差异更大，功能限制评分的加速率更高。
结果表明，在超过十年的时间里，功能通过两种途径发展，尤其是在接近诊断时。基于性别和疾病诊断后年限的个体轨迹的差异表明，男性和女性多发性硬化症患者可能会随着年龄的增长对其功能有不同的感知。这对向男性和女性多发性硬化症患者提供临床建议有影响。
