Wandall-Holm Malthe Faurschou, Holm Rolf Pringler, Pontieri Luigi, Sellebjerg Finn, Magyari Melinda
Danish Multiple Sclerosis Registry, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Department of Neurology, Danish Multiple Sclerosis Center, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark.
Front Neurol. 2023 Jun 13;14:1214897. doi: 10.3389/fneur.2023.1214897. eCollection 2023.
INTRODUCTION/OBJECTIVES: Multiple sclerosis (MS) leads to physical and cognitive disability, which in turn impacts the socioeconomic status of the individual. The altered socioeconomic trajectory combined with the critical role of aging in MS progression could potentially lead to pronounced differences between MS patients and the general population. Few nations have the ability to connect long-term clinical and socioeconomic data at the individual level, and Denmark's robust population-based registries offer unique insights. This study aimed to examine the socioeconomic aspects of elderly Danish MS patients in comparison to matched controls from the general population.
A nationwide population-based study in Denmark was conducted, comprising all living MS patients aged 50 years or older as of 1 January 2021. Patients were matched 1:10 based on sex, age, ethnicity, and residence with a 25% sample of the total Danish population. Demographic and clinical information was sourced from the Danish Multiple Sclerosis Registry, while socioeconomic data were derived from national population-based registries containing details on education, employment, social services, and household characteristics. Univariate comparisons between MS patients and matched controls were then carried out.
The study included 8,215 MS patients and 82,150 matched individuals, with a mean age of 63.4 years (SD: 8.9) and a 2:1 female-to-male ratio. For those aged 50-64 years, MS patients demonstrated lower educational attainment (high education: 28.3 vs. 34.4%, < 0.001) and fewer received income from employment (46.0 vs. 78.9%, < 0.001), and working individuals had a lower annual income (48,500 vs. 53,500€, < 0.001) in comparison to the controls. Additionally, MS patients within this age group were more likely to receive publicly funded practical assistance (14.3 vs. 1.6%, < 0.001) and personal care (10.5 vs. 0.8%, < 0.001). Across the entire population, MS patients were more likely to live alone (38.7 vs. 33.8%, < 0.001) and less likely to have one or more children (84.2 vs. 87.0%, < 0.001).
MS presents significant socioeconomic challenges among the elderly population, such as unemployment, reduced income, and increased dependence on social care. These findings underscore the pervasive impact of MS on an individual's life course, extending beyond the clinical symptoms of cognitive and physical impairment.
引言/目的：多发性硬化症（MS）会导致身体和认知残疾，进而影响个人的社会经济地位。社会经济轨迹的改变，再加上衰老在MS进展中的关键作用，可能会导致MS患者与普通人群之间存在明显差异。很少有国家能够将个体层面的长期临床和社会经济数据联系起来，而丹麦强大的基于人群的登记系统提供了独特的见解。本研究旨在比较丹麦老年MS患者与来自普通人群的匹配对照组的社会经济状况。
在丹麦进行了一项全国性的基于人群的研究，纳入了截至2021年1月1日所有年龄在50岁及以上的在世MS患者。根据性别、年龄、种族和居住地，患者与丹麦总人口的25%样本以1:10的比例进行匹配。人口统计学和临床信息来自丹麦多发性硬化症登记处，而社会经济数据则来自包含教育、就业、社会服务和家庭特征详细信息的全国性基于人群的登记处。然后对MS患者和匹配对照组进行单变量比较。
该研究纳入了8215名MS患者和82150名匹配个体，平均年龄为63.4岁（标准差：8.9），女性与男性的比例为2:1。对于50 - 64岁的人群，MS患者的受教育程度较低（高等教育：28.3%对34.4%，<0.001），就业收入者较少（46.0%对78.9%，<0.001），与对照组相比，在职个体的年收入较低（48500欧元对53500欧元，<0.001）。此外，该年龄组的MS患者更有可能接受公共资助的实际援助（14.3%对1.6%，<0.001）和个人护理（10.5%对0.8%，<0.001）。在整个人口中，MS患者更有可能独自生活（38.7%对33.8%，<0.001），并且生育一个或多个孩子的可能性较小（84.2%对87.0%，<0.001）。
MS在老年人群中带来了重大的社会经济挑战，如失业、收入减少和对社会护理的依赖增加。这些发现强调了MS对个人生命历程的广泛影响，超出了认知和身体损伤的临床症状。
