title: The first 10 years with multiple sclerosis: the longitudinal course of daily functioning.
abstract: OBJECTIVE
  To determine the course of daily functioning in patients with multiple sclerosis in the 10 years after their definite diagnosis.
  
  
  METHODS
  A long-term prospective follow-up study including an incidence cohort of 156 patients with multiple sclerosis. Participants were examined systematically, beginning immediately after definite diagnosis, then at the following time-points: 6 months, 1, 2, 3, 6 and 10 years. The various domains of daily functioning were assessed with the Expanded Disability Status Scale, the Functional Independence Measure, and the Medical Outcome Study Short Form-36 (SF-36).
  
  
  RESULTS
  Neurological disability and physical functioning worsened significantly, with a time course dependent on whether a patient had multiple sclerosis of the relapse onset type or non-relapse onset type. Cognitive and social functioning worsened significantly over time, but with the same (accelerated) rate of change in both the RO and NRO groups. Scores on SF-36 mental health, SF-36 role physical, and SF-36 general health changed only slightly.
  
  
  CONCLUSIONS
  In the first 10 years after definite diagnosis, patients with multiple sclerosis showed a more pronounced decline in physical functioning than in cognitive and social functioning. There was no time-related decline in mental health, social role due to physical limitations, or general health.
authors.affiliation: Department of Rehabilitation Medicine, VU University Medical Center, PO Box 7057, NL-1007 MB Amsterdam, The Netherlands. h.beckerman@vumc.nl
authors.forename: Heleen
authors.initials: H
authors.lastname: Beckerman
authors.forename: Jiska C E
authors.initials: JC
authors.lastname: Kempen
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Chris H
authors.initials: CH
authors.lastname: Polman
authors.forename: Gustaaf J
authors.initials: GJ
authors.lastname: Lankhorst
authors.forename: Vincent
authors.initials: V
authors.lastname: de Groot
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology / Q000534:rehabilitation*; D011446:Prospective Studies; D013997:Time Factors