Obesity linked to disability worsening, declining quality of life in MS

Key takeaways:

• A study followed more than 3,000 adults for up to 15 years post-MS diagnosis.
• Obesity was associated with increased risk of disability, physical and psychological worsening.

WEST PALM BEACH, Fla. — Obesity was strongly associated with disability worsening, disease progression and declining quality of life in a cohort of adults diagnosed with multiple sclerosis, according to a presenter at ACTRIMS 2024.

“Obesity is related to the risk to develop multiple sclerosis,” Lars Alfredsson, PhD, a professor at the Institute of Environmental Medicine, Karolinska Institute in Stockholm, told attendees. “But when it comes to disease progression, much less is known.”

Alfredsson and colleagues sought to examine the influence of BMI on disease progression, cognitive performance, and health-related quality of life in adults with MS.

Their population-based case-control study included 3,249 individuals (mean age 37.8 years; 74% female) who were categorized based on BMI status at diagnosis. All participants answered a thorough questionnaire at baseline covering lifestyle and environmental concerns that may affect disease progression. They were subsequently followed up to 15 years post-diagnosis through the Swedish MS registry and tracked by answers to another questionnaire in 2021 regarding changes in Expanded Disability Status (EDSS) scale, Multiple Sclerosis Impact Scale 29, and Symbol Digit Modalities Test (SDMT).

The researchers utilized linear mixed models to analyze long-term changes and employed Cox regression models quantified as hazard risk to analyze risk of 24-week confirmed disability worsening, time to scores of EDSS 3 and EDSS 4 indicating an increase of disability, patient-reported physical and psychological worsening, along with processing speed worsening.

According to results, obesity was associated with a 0.022-point faster annual increase in EDSS score (beta for EDSS x time 0.022, 95% CI. 0.003-0.041) compared with normal weight. Obesity was also associated with an increased risk of reaching EDSS 3 (HR = 1.43, 95% CI, 1.17-1.75) and EDSS 4 (HR = 1.33; 95% CI, 1.05-1.7), indicated with an increased risk of physical and psychological worsening.

Data also showed, among participants who had not changed BMI group during follow-up, the HR of cognitive disability worsening was 1.47 (95% CI, 1.08-2.01) among participants with obesity, compared with those without.

“Obesity compares negatively with both disease progression, health-related quality of life and cognitive function,” Alfredsson said.