title: Physical and mental health comorbidity is common in people with multiple sclerosis: nationally representative cross-sectional population database analysis.
abstract: BACKGROUND
  Comorbidity in Multiple Sclerosis (MS) is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in people with MS.
  
  
  METHODS
  39 comorbidities in 3826 people with MS aged ≥25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression.
  
  
  RESULTS
  People with MS were more likely to have one (OR 2.44; 95% CI 2.26-2.64), two (OR 1.49; 95% CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95% CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95% CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95% CI 0.36-0.67), chronic kidney disease (OR 0.51; 95% CI 0.40-0.65), heart failure (OR 0.62; 95% CI 0.45-0.85), coronary heart disease (OR 0.64; 95% CI 0.52-0.71), and hypertension (OR 0.65; 95% CI 0.59-0.72) were significantly less common in people with MS.
  
  
  CONCLUSIONS
  People with MS have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation.
authors.affiliation: General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, Scotland, UK. Robert.Simpson@glasgow.ac.uk.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Simpson
authors.forename: Gary
authors.initials: G
authors.lastname: McLean
authors.forename: Bruce
authors.initials: B
authors.lastname: Guthrie
authors.forename: Frances
authors.initials: F
authors.lastname: Mair
authors.forename: Stewart W
authors.initials: SW
authors.lastname: Mercer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D011153:Population; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult