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A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: changes in disability and the value of different factors in predicting disability and mortality.

https://arctichealth.org/en/permalink/ahliterature108382
Source
J Neurol Sci. 2013 Sep 15;332(1-2):121-7
Publication Type
Article
Date
Sep-15-2013
Author
Charlotte Chruzander
Sverker Johansson
Kristina Gottberg
Ulrika Einarsson
Sten Fredrikson
Lotta Widén Holmqvist
Charlotte Ytterberg
Author Affiliation
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden. charlotte.chruzander@ki.se
Source
J Neurol Sci. 2013 Sep 15;332(1-2):121-7
Date
Sep-15-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Community Health Planning
Disability Evaluation
Disabled Persons
Female
Humans
Longitudinal Studies
Male
Middle Aged
Multiple Sclerosis - epidemiology - mortality - physiopathology
Predictive value of tests
Sweden - epidemiology
Walking - physiology
Abstract
Most people with multiple sclerosis (PwMS) experience progressively worsening disability over a period of decades, thus further knowledge about the long-term changes in different areas of disability is essential.
The aims of this study were to evaluate changes in disability over ten years in PwMS, and to explore the value of personal and disease-specific factors and depressive symptoms in predicting disability. A further aim was to explore the value of these factors as predictors of mortality.
This study was based on a 10-year follow-up of a population-based study in Stockholm (n=166). Home visits were used to collect data on personal and disease-specific factors, walking ability, manual dexterity, cognitive function, mood, activities of daily living (ADL) and social/lifestyle activities.
The proportion of the study population who had disability in cognition, mood and social/lifestyle activities remained stable, while the proportion with disability in walking, manual dexterity and ADL increased. Disease severity predicted an increase in all studied variables of disability except in depressive symptoms. Older age and depressive symptoms were associated with mortality.
This study illustrates the importance of tailored interventions for PwMS and highlights the need for health-care professionals to consider the psychological aspects of the disease. Furthermore, our results indicate that the Expanded Disability Status Scale was a useful tool for predicting future disability.
PubMed ID
23896259 View in PubMed
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A 10-year population-based study of people with multiple sclerosis in Stockholm, Sweden: use of and satisfaction with care and the value of different factors in predicting use of care.

https://arctichealth.org/en/permalink/ahliterature275585
Source
BMC Health Serv Res. 2015;15:480
Publication Type
Article
Date
2015
Author
Charlotte Chruzander
Sverker Johansson
Kristina Gottberg
Ulrika Einarsson
Jan Hillert
Lotta Widén Holmqvist
Charlotte Ytterberg
Source
BMC Health Serv Res. 2015;15:480
Date
2015
Language
English
Publication Type
Article
Keywords
Ambulatory Care - utilization
Disabled Persons - psychology - statistics & numerical data
Epidemiologic Methods
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Multiple Sclerosis - epidemiology - psychology - therapy
Patient Acceptance of Health Care - psychology
Patient Satisfaction - statistics & numerical data
Primary Health Care - utilization
Sweden - epidemiology
Abstract
The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, disease-specific factors and functioning on the use of care and to explore patient satisfaction with care in a 10-year perspective.
Information regarding personal factors, disease-specific factors, functioning and satisfaction with care was collected by home-visits; use of care was collected from the Stockholm County Council computerised register.
Data from 121 people with MS (PwMS) was collected. Primary care accounted for the majority of all care. Neurology and Rehabilitation Departments together accounted for two-thirds of all hospital outpatient care. Rehabilitation Departments accounted for one-third of the total number of inpatient days. Lower coping capacity, impaired manual dexterity and activity of daily living dependency at baseline, together with progress in MS disability predicted a higher use of care. Overall, patient satisfaction with care was stable over time.
The extensive use of care offers challenges to care coordination. Implementation of person-centred care could be a strategy to increase efficacy/outcome of care.
Notes
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PubMed ID
26499940 View in PubMed
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A 50-year follow-up of the incidence of multiple sclerosis in Hordaland County, Norway.

https://arctichealth.org/en/permalink/ahliterature82860
Source
Neurology. 2006 Jan 24;66(2):182-6
Publication Type
Article
Date
Jan-24-2006
Author
Grytten N.
Glad S B
Aarseth J H
Nyland H.
Midgard R.
Myhr K-M
Author Affiliation
National Multiple Sclerosis Competence Centre, Haukeland University Hospital, Bergen, Norway. nina.grytten@helse-bergen.no
Source
Neurology. 2006 Jan 24;66(2):182-6
Date
Jan-24-2006
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Female
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Multiple Sclerosis - epidemiology
Norway - epidemiology
Prevalence
Sex Distribution
Abstract
OBJECTIVE: To assess longitudinal follow-up of the incidence of multiple sclerosis (MS) through five decades and estimate the prevalence rate in Hordaland County, Norway, on January 1, 2003. METHODS: All patients with MS diagnosed from 1953 to 2003 were identified in the patient records of the Department of Neurology, Haukeland University Hospital, Bergen, Norway. The diagnostic criteria of Poser et al. were applied and only patients with definite and probable MS were included. The study comprises 912 patients, and 666 patients with MS were living in Hordaland on January 1, 2003. The annual incidence rates for the years 1953 to 2003 were calculated. RESULTS: The total crude prevalence rate on January 1, 2003, was 150.8 per 100,000 population: 191.3 per 100,000 among women and 109.8 per 100,000 among men. The annual incidence of MS increased from 1.8 per 100,000 in 1953 to 1957 to 6.0 per 100,000 in 1993 to 1997. CONCLUSIONS: Hordaland County, Norway, has changed from a low-risk to a high-risk area for multiple sclerosis (MS) during the last 50 years. During the last 25 years, the incidence of MS has been stable rather than increasing. Systematic longitudinal follow-up studies are essential to calculate reliable prevalence and incidence rates in MS. The results suggest that both methodologic and environmental factors are essential in determining the distribution of MS.
PubMed ID
16434650 View in PubMed
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Absence of HTLV-1 related sequences in MS from high prevalence areas in western Norway.

https://arctichealth.org/en/permalink/ahliterature219178
Source
Acta Neurol Scand. 1994 Jan;89(1):65-8
Publication Type
Article
Date
Jan-1994
Author
K M Myhr
P. Frost
M. Grønning
R. Midgard
K H Kalland
D E Helland
H I Nyland
Author Affiliation
Department of Neurology, University of Bergen, Norway.
Source
Acta Neurol Scand. 1994 Jan;89(1):65-8
Date
Jan-1994
Language
English
Publication Type
Article
Keywords
Adult
Blotting, Southern
Cross-Sectional Studies
Female
HTLV-I Infections - epidemiology
Humans
Incidence
Male
Middle Aged
Multiple Sclerosis - epidemiology
Norway - epidemiology
Polymerase Chain Reaction
Risk factors
Abstract
In Western Norway, long-term follow up epidemiological studies have revealed significant increases in the incidence and prevalence rates of multiple sclerosis (MS) in stable populations, indicating the impact of exogenous factors. In this study 183 MS patients and 102 controls from high prevalence areas in Western Norway were investigated for human T-lymphotropic virus type I (HTLV-1) related sequences by polymerase chain reaction. Using primers targeting the gag, pol and env genes in the HTLV-1 provirus genome, no amplification products were detected in the 183 MS patients or 102 controls. The results strongly suggest that neither HTLV-1 nor a closely related retrovirus participate in the aetiology of MS.
Notes
Erratum In: Acta Neurol Scand 1994 Aug;90(2):143
PubMed ID
8178631 View in PubMed
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Age at Menarche and Risk of Multiple Sclerosis: A Prospective Cohort Study Based on the Danish National Birth Cohort.

https://arctichealth.org/en/permalink/ahliterature282031
Source
Am J Epidemiol. 2017 Apr 15;185(8):712-719
Publication Type
Article
Date
Apr-15-2017
Author
Nete Munk Nielsen
Maria Harpsøe
Jacob Simonsen
Egon Stenager
Melinda Magyari
Nils Koch-Henriksen
Jennifer L Baker
Henrik Hjalgrim
Morten Frisch
Peter Bager
Source
Am J Epidemiol. 2017 Apr 15;185(8):712-719
Date
Apr-15-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Child
Denmark - epidemiology
Female
Humans
Interviews as Topic
Menarche
Multiple Sclerosis - epidemiology - etiology
Proportional Hazards Models
Prospective Studies
Registries
Risk factors
Young Adult
Abstract
Few studies have addressed the possible association between age at menarche and multiple sclerosis (MS), and results are conflicting. We studied this issue in a large prospective cohort study. The study cohort comprised 77,330 women included in the Danish National Birth Cohort (1996-2002). Information on menarcheal age was ascertained at the first interview, which took place in the 16th week of pregnancy. Women were followed for MS from the first interview to December 31, 2011. Associations between age at menarche and risk of MS were evaluated with hazard ratios and 95% confidence intervals using Cox proportional hazards regression models. Overall, 226 women developed MS during an average follow-up period of 11.7 years. Age at menarche among women with MS was generally lower than that among women without MS (Wilcoxon rank-sum test; P = 0.002). We observed an inverse association between age at menarche and MS risk. For each 1-year increase in age at menarche, risk of MS was reduced by 13% (hazard ratio = 0.87, 95% confidence interval: 0.79, 0.96). Early age at menarche appears to be associated with an increased risk of MS. The mechanisms behind this association remain to be established.
PubMed ID
28369233 View in PubMed
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Age at onset of multiple sclerosis may be influenced by place of residence during childhood rather than ancestry.

https://arctichealth.org/en/permalink/ahliterature170585
Source
Neuroepidemiology. 2006;26(3):162-7
Publication Type
Article
Date
2006
Author
J. Kennedy
P. O'Connor
A D Sadovnick
M. Perara
I. Yee
B. Banwell
Author Affiliation
The Hospital for Sick Children, University of Toronto, Toronto, Ont. L5M 4A7, Canada.
Source
Neuroepidemiology. 2006;26(3):162-7
Date
2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Aged
Asia - ethnology
Caribbean Region - ethnology
Child
Child, Preschool
Cohort Studies
Emigration and Immigration
Europe - ethnology
Humans
Middle Aged
Multiple Sclerosis - epidemiology
Ontario - epidemiology
Residence Characteristics
Risk factors
Abstract
Multiple sclerosis (MS) most commonly affects individuals of Northern European descent who live in countries at high latitude. The relative contributions of ancestry, country of birth and residence as determinants of MS risk have been studied in adult MS, but have not been explored in the pediatric MS population. In this study, we compare the demographics of pediatric- and adult-onset MS patients cared for in Toronto, Ontario, Canada, a multicultural region. The country of birth, residence during childhood, and ancestry were compared for 44 children and 573 adults. Our results demonstrate that although both the pediatric and adult cohorts were essentially born and raised in the same region of Ontario, Canada, children with MS were more likely to report Caribbean, Asian or Middle Eastern ancestry, and were less likely to have European heritage compared with individuals with adult-onset MS. The difference in ancestry between the pediatric and adult MS cohorts can be explained by two hypotheses: (1) individuals raised in a region of high MS prevalence, but whose ancestors originate from regions in which MS is rare, have an earlier age of MS onset, and (2) the place of residence during childhood, irrespective of ancestry, determines lifetime MS risk -- a fact that will be reflected in a change in the demographics of the adult MS cohort in our region as Canadian-raised children of recent immigrants reach the typical age of adult-onset MS.
PubMed ID
16493204 View in PubMed
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Alaska, multiple sclerosis, and the vitamin D hypothesis.

https://arctichealth.org/en/permalink/ahliterature147699
Source
J Neurol. 2010 Feb;257(2):305-6
Publication Type
Article
Date
Feb-2010

Alcohol as a modifiable lifestyle factor affecting multiple sclerosis risk.

https://arctichealth.org/en/permalink/ahliterature105402
Source
JAMA Neurol. 2014 Mar;71(3):300-5
Publication Type
Article
Date
Mar-2014
Author
Anna Karin Hedström
Jan Hillert
Tomas Olsson
Lars Alfredsson
Author Affiliation
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Source
JAMA Neurol. 2014 Mar;71(3):300-5
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol drinking - epidemiology
Case-Control Studies
Dose-Response Relationship, Drug
Female
Humans
Life Style
Male
Middle Aged
Multiple Sclerosis - epidemiology
Registries
Risk
Smoking - epidemiology
Sweden - epidemiology
Young Adult
Abstract
Alcohol consumption may be a modifiable lifestyle factor that affects the risk of developing multiple sclerosis (MS). Results of previous studies have been inconsistent.
To investigate the possible association of alcohol consumption with the risk of developing MS and to relate the influence of alcohol to the effect of smoking.
This report is based on 2 case-control studies: Epidemiological Investigation of Multiple Sclerosis (EIMS) included 745 cases and 1761 controls recruited from April 2005 to June 2011, and Genes and Environment in Multiple Sclerosis (GEMS) recruited 5874 cases and 5246 controls between November 2009 and November 2011. All cases fulfilled the McDonald criteria. Both EIMS and GEMS are population-based studies of the Swedish population aged 16 to 70 years. In EIMS, incident cases of MS were recruited via 40 study centers, including all university hospitals in Sweden. In GEMS, prevalent cases were identified from the Swedish national MS registry. In both studies, controls were randomly selected from the national population register, matched by age, sex, and residential area at the time of disease onset.
Multiple sclerosis status.
There was a dose-dependent inverse association between alcohol consumption and risk of developing MS that was statistically significant in both sexes. In EIMS, women who reported high alcohol consumption had an odds ratio (OR) of 0.6 (95% CI, 0.4-1.0) of developing MS compared with nondrinking women, whereas men with high alcohol consumption had an OR of 0.5 (95% CI, 0.2-1.0) compared with nondrinking men. The OR for the comparison in GEMS was 0.7 (95% CI, 0.6-0.9) for women and 0.7 (95% CI, 0.2-0.9) for men. In both studies, the detrimental effect of smoking was more pronounced among nondrinkers. CONCLUSIONS AND RELEVANCE; Alcohol consumption exhibits a dose-dependent inverse association with MS. Furthermore, alcohol consumption is associated with attenuation of the effect of smoking. Our findings may have relevance for clinical practice because they give no support for advising patients with MS to completely refrain from alcohol.
PubMed ID
24395432 View in PubMed
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All-cause mortality following a cancer diagnosis amongst multiple sclerosis patients: a Swedish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature269826
Source
Eur J Neurol. 2015 Jul;22(7):1074-80
Publication Type
Article
Date
Jul-2015
Author
H. Roshanisefat
S. Bahmanyar
J. Hillert
T. Olsson
S. Montgomery
Source
Eur J Neurol. 2015 Jul;22(7):1074-80
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Comorbidity
Female
Humans
Male
Middle Aged
Mortality
Multiple Sclerosis - epidemiology - mortality
Neoplasms - epidemiology - mortality
Registries - statistics & numerical data
Risk
Sweden - epidemiology
Young Adult
Abstract
A reduced cancer risk amongst patients with multiple sclerosis (MS) has been reported. Theoretically, this could represent a genuine reduction in risk or, alternatively, 'diagnostic neglect', where cancer is undiagnosed when symptoms are misattributed to MS.
Assess all-cause mortality risk following a cancer diagnosis in patients with MS compared with a cohort without MS.
A cohort of MS patients (n = 19,364) and a cohort of the general population (n = 192,519) were extracted from national Swedish registers from 1969 to 2005. All-cause mortality after cancer in MS was compared with the general population. Poisson regression analysis was conducted in the MS and non-MS cohorts separately. The models were adjusted for follow-up duration, year at entry, sex, region and socioeconomic index. The two cohorts were combined and differences in mortality risk were assessed using interaction testing.
The adjusted relative risk (and 95% confidence interval) for all-cause mortality following a cancer diagnosis in MS patients (compared with MS patients without cancer) is 3.06 (2.86-3.27; n = 1768) and amongst those without MS 5.73 (5.62-5.85; n = 24,965). This lower magnitude mortality risk in the MS patients was confirmed by multiplicative interaction testing (P
PubMed ID
25903644 View in PubMed
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Alterations in KLRB1 gene expression and a Scandinavian multiple sclerosis association study of the KLRB1 SNP rs4763655.

https://arctichealth.org/en/permalink/ahliterature134204
Source
Eur J Hum Genet. 2011 Oct;19(10):1100-3
Publication Type
Article
Date
Oct-2011
Author
Helle Bach Søndergaard
Finn Sellebjerg
Jan Hillert
Tomas Olsson
Ingrid Kockum
Magdalena Lindén
Inger-Lise Mero
Kjell-Morten Myhr
Elisabeth G Celius
Hanne F Harbo
Jeppe Romme Christensen
Lars Börnsen
Per Soelberg Sørensen
Annette Bang Oturai
Author Affiliation
Department of Neurology, Danish Multiple Sclerosis Center, University Hospital Rigshospitalet, Copenhagen, Denmark. hbs@rh.dk
Source
Eur J Hum Genet. 2011 Oct;19(10):1100-3
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Case-Control Studies
Female
Gene Expression Regulation
Gene Frequency
Genetic Predisposition to Disease
Genome-Wide Association Study
Humans
Male
Multiple Sclerosis - epidemiology - genetics
NK Cell Lectin-Like Receptor Subfamily B - genetics - metabolism
Polymorphism, Single Nucleotide
Scandinavia - epidemiology
Abstract
Multiple sclerosis (MS) is a complex autoimmune disease affecting genetically susceptible individuals. A genome-wide association study performed by the International MS Genetics Consortium identified several putative susceptibility genes; among these, the KLRB1 gene is represented by the single-nucleotide polymorphism rs4763655. We could confirm a marginally significant association between rs4763655 and MS (P=0.046, odds ratio=1.06 (1.00-1.13)) in a large Scandinavian case-control study of 5367 MS patients and 4485 controls. The expression of KLRB1 in blood from MS patients was higher compared with healthy controls (P
Notes
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PubMed ID
21610746 View in PubMed
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379 records – page 1 of 38.