title: 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.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden. charlotte.chruzander@ki.se
authors.forename: Charlotte
authors.initials: C
authors.lastname: Chruzander
authors.forename: Sverker
authors.initials: S
authors.lastname: Johansson
authors.forename: Kristina
authors.initials: K
authors.lastname: Gottberg
authors.forename: Ulrika
authors.initials: U
authors.lastname: Einarsson
authors.forename: Sten
authors.initials: S
authors.lastname: Fredrikson
authors.forename: Lotta Widén
authors.initials: LW
authors.lastname: Holmqvist
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ytterberg
mesh_terms: D000367:Age Factors; D000368:Aged; D018672:Community Health Planning; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D013548:Sweden / Q000453:epidemiology; D016138:Walking / Q000502:physiology
keywords: Disability; Epidemiology; Functioning; Longitudinal; Multiple sclerosis; Prognostic factors