Low Socioeconomic, Education Levels Linked to Higher Disability and Disease Progression in MS, Study Says

Low Socioeconomic, Education Levels Linked to Higher Disability and Disease Progression in MS, Study Says

Low income and education levels are linked to a higher risk of physical disability and disease progression in patients with multiple sclerosis (MS), study says.

The study with that finding, “Socioeconomic status and disability progression in multiple sclerosis,” was published in the journal Neurology.

“This study is the first of its kind,” Helen Tremlett, PhD, the study’s senior author, said in a press release. Tremlett is a professor at the University of British Columbia (UBC) and the Canada Research Chair in neuroepidemiology and MS.

“Previous studies have looked at the relationship between socioeconomic status and risk of developing MS. Here, we were able to show a relationship between socioeconomic status and subsequent risk of disability progression,” Tremlett said.

MS is a progressive, neurodegenerative, autoimmune disease characterized by different types and degrees of physical disabilities. The impact of patients’ socioeconomic status on MS progression and physical disability is controversial. “These discrepancies might relate to variability between study designs, especially when adjusting for lifestyle factors, which can change over time,” the researchers wrote.

In the study, a team of scientists from UBC, Canada, together with collaborators from Wales, U.K., set out to assess whether the socioeconomic status and education level of MS patients were linked to disease progression and physical disabilities.

To this end, researchers gathered health, economic, and education data from two different groups of MS patients stored on census records, and on two MS online databases. The study included a total of 3,113 MS patients — 2,069 from British Columbia (Canada), and 1,044 from Southeast Wales (U.K.).

The patients’ socioeconomic status was evaluated before MS onset, to eliminate any potential confounding factors, and was based on neighborhood-level average income. Physical disability was evaluated using the Expanded Disability Status Scale (EDSS, the higher the score, the worse the patient’s disability).

Results showed that high socioeconomic status, as well as education levels, were associated with a low risk of high EDSS scores, and a low risk of developing secondary progressive MS (SPMS). Conversely, low socioeconomic status and/or education levels were linked to a high risk of moderate/severe physical impairment and SPMS.

These findings were not surprising for Marilyn Lenzen, a 59-year-old patient living in North Vancouver, Canada, who was diagnosed with MS nearly 20 years ago.

“I’m glad to see that there is now research that backs up what I and many in the MS community have been experiencing for years,” said Lenzen. “Someone who has the financial means to buy healthier food or afford to participate in yoga, pilates or specialized exercise to rebuild their strength after a relapse doesn’t experience the same progression of disabling symptoms as others who can’t afford to access the same healthy lifestyle choices,” she said.

The team did not analyze which factors might account for this inverse relationship between patients’ socioeconomic status/education level and higher risk of MS disability and progression, but argue that several lifestyle parameters, including diet and exercise, may be involved.

“If that is the case, the risk may be amenable to change,” said Tremlett. “One of the next steps is to understand why this relationship exists.”

In the future, the team hopes that more MS studies will take into account the socioeconomic status and education level of patients, since these parameters seem to play an important role in disease progression and physical disability.

“I wish that everyone with MS, regardless of their socioeconomic status, has the same lifestyle opportunities to slow the progression of their disease,” Lenzen concluded.


    • Sandra says:

      I agree with you it does offend a lot of us with P.P. M.S. .It should had been wrote better or thought about how they ended it. We all do not have the funds to pay for everything they want done. They found mine late when my husband was planning on retiring and has worked hard for a company as a electrician went to school for it. But now I am I’ll and cannot retire to pay for my meds and treatment. Because the company and our state wants to cut his retirement. I take it only the rich get the best. We were content until I got sick. And 99 percent of meds I have reaction to.

    • Denise Gibson says:

      I am living proof that this is indeed true! I’ve been saying this since I was stuck down with MS in 2011. Now I am in a wheelchair now and still have no medical coverage or any help for my condition!

  1. This article can be debunked. I think there is a correlation, but I do not think it holds true for every case. Sadly, if you have money, you can afford the best of everything ~ meds, Stem cell therapy, food, assistance with cooking, cleaning, a driver, a nanny, etc., and that has no reflection on what type of education you have.

    I was Dx at a young age. I was a vegetarian at the time, and I grew up in Canada, but ate fresh fruis and veggies from our garden and fruit trees. So, I think this “study” can go back to the drawing board. I have a college degree, but, I can no longer work. So much for that eduction now!

    Anyway, I am trying to stay positive, but this article is bogus.

  2. Janey5 says:

    I agree that this is controversial, and certainly would be interesting to have more facts and historical data built into this study.
    I was dx RRMS 11 years ago but since the previous WIRMS trial I took part in have gained greater knowledge and links have been made to my unexplained childhood “episodes”. I also feel a transition looming to SSMS, since my lesion activity is predominantly in my cervical spine and I am in my mid 40’s.
    I think we need trials like this, we need strong relationships between our neuro teams and MS’ers so the right background information is discussed.
    I’d be interested to know where the health of siblings/ family/ friends stands as a control to lifestyle standards, as most people I’ve known throughout my life must be in the same dynamic? I’m a healthy eater, I exercise, I noticed my first adult exacerbation during exercise. MS Bloggers I’m ve followed often have to adapt their healthy lifestyle and exercise routines because of their MS.
    There may be worthwhile patterns to be sought. I could draw parallels with many less healthy people, faddy eaters (particularly in childhood), less active , less time outdoors. I feel there is a long way to go to gain any real insight.
    The worldwide prevalence of MS appears lowest around the equator and highest throughout north America and Europe,which is perhaps quite opposite to the distribution of wealth, does this still relate or is that a further environmental factor at work (e.g. healthy bacteria balancing digestive systems, diet of whole foods, sunlight levels, use of antibiotics…..)?
    We need to take care of our bodies in the healthiest ways possible, we need nutrients, we need water, we need sunlight, education is good. I’d like to know more, I’d like a less vague perspective of this.
    Have we created a lifestyle so far from our ancestors that our bodies are no longer living in harmony with the world we live in?

  3. Robin says:

    I’ve often thought that having MS is an expensive disease, especially since insurance (if you have it)) doesn’t always cover the amount of physical therapy that people could benefit from, or some of the complementary modalities that may be useful.

    It’s worth pointing out that even if the risk of SPMS may be higher for lower income and education groups, not everyone with SPMS is from those groups. Likewise, being from those groups doesn’t necessarily doom someone to SPMS.

    The real value of studies like these is helping make the argument that “lifestyle” factors can impact MS. I often read “there’s no evidence that diet X works” or “no one has demonstrated that modality Y helps.” And because there’s rarely an economic incentive for researchers to conduct formal clinical trials on these interventions, the situation doesn’t change. Maybe studies like these can be the “proof” that is needed to get people with MS the resources they need.

  4. Peggy Boren says:

    What a waste of money. If you have more money you can afford better lifestyles which in turn helps your treatment. Your doing good with PT but can’t afford, can’t afford a chef, can’t go to where best treatment exist.

    If scientists would work together for a cure instead of multiple companies working on treatments maybe we would see results.


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