Vitality, perceived social support and disease activity determine the performance of social roles in recently diagnosed multiple sclerosis: a longitudinal analysis.
OBJECTIVE
The aim of this study was to identify the principal determinants that are longitudinally associated with the performance of social roles in the first 3 years following a diagnosis of multiple sclerosis.


METHODS
Inception cohort with 5 measurements over 3 years.


METHODS
A total of 156 patients recently diagnosed with multiple sclerosis.


METHODS
Performance of social roles was measured using the 2 role functioning and the social sub-scales of the Medical Outcome Study Short Form 36. Potential determinants (n = 43) were divided into the following clusters: patient and disease characteristics (n = 12), psychosocial characteristics (n = 10), basic functions (n = 18) and basic activities (n = 3). Multivariate longitudinal regression analyses were performed with generalized estimating equations. A backwards selection procedure for every cluster per outcome reduced the large number of potential determinants. In order to determine whether longitudinal associations are present the selected determinants were entered into an overall regression model.


RESULTS
Twenty-three candidate determinants were selected. Vitality, measured with the SF36 sub-scale vitality, the T2-weighted supratentorial lesion load and the perceived amount of social support, measured with the Social Support List Discrepancies, were longitudinally associated with the performance of social roles in 2 or 3 of the models.


CONCLUSIONS
Vitality, the perceived amount of social support, and disease activity, i.e. the T2-weighted supratentorial lesion load, determine the performance of social roles in the early stages of multiple sclerosis.
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. v.degroot@vumc.nl
Vincent
V
de Groot
Heleen
H
Beckerman
Jos W
JW
Twisk
Bernard M
BM
Uitdehaag
Rogier Q
RQ
Hintzen
Arjan
A
Minneboo
Gustaaf J
GJ
Lankhorst
Chris H
CH
Polman
Lex M
LM
Bouter
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011379:Prognosis; D011597:Psychomotor Performance; D011788:Quality of Life; D012917:Social Adjustment; D012944:Social Support