Physical and Mental Health Comorbidities Among Adults With Multiple Sclerosis

Objective: To compare the incidence of and adjusted hazard ratios for common cardiometabolic diseases, musculoskeletal disorders, and psychological morbidities among adults with and without multiple sclerosis (MS).

Patients And Methods: Beneficiaries were included if they had an diagnostic code for MS (n=9815) from a national private insurance claims database (Clinformatics Data Mart; OptumInsight). Adults without MS were also included (n=1,474,232) as a control group. Incidence estimates of common cardiometabolic diseases, musculoskeletal disorders, and psychological morbidities were compared at 5 years of continuous enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident morbidities.

Results: Adults with MS had a higher incidence of common cardiometabolic disease (51.6% [2663 of 5164] vs 36.4% [328,690 of 904,227]), musculoskeletal disorder (68.8% [3411 of 4959] vs 47.5% [512,422 of 1,077,737]), and psychological morbidity (49.4% [3305 of 6691] vs 30.8% [380,893 of 1,235,388]) than adults without MS, and differences were clinically meaningful (all <.001). Fully adjusted survival models revealed that adults with MS had a greater risk for (hazard ratio [HR], 1.37; 95% CI, 1.32 to 1.43) and (HR, 1.19 to 1.48) common cardiometabolic diseases, (HR, 1.59; 95% CI, 1.53 to 1.64) and (HR, 1.22 to 2.77) musculoskeletal disorders, and (HR, 1.57; 95% CI, 1.51 to 1.62) and (HR, 1.20 to 2.51) but one (impulse control disorders) psychological morbidity.

Conclusion: Adults with MS have a significantly higher risk for development of common cardiometabolic diseases, musculoskeletal disorders, and psychological morbidities (all <.001) than adults without MS. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce risk of chronic physical and mental disease onset/progression in this higher risk population.