ABSTRACT
The aim of this study was to ascertain the prevalence of multiple sclerosis (MS) in a northern Spanish region and to compare it with that from the most recent epidemiological studies in the country. MS prevalence was studied for a period of 2 years using multiple sources of information in the province of Valladolid, with a sample comprising a total population of 92,632. Patients were classified according to the Poser criteria. The crude prevalence of definite and probable MS was 58.3 per 100,000 (95% confidence interval: 43.7-75.7). The same methods have been used in ascertaining similar prevalence rates in Vélez-Málaga, Osona, and Gijón and a slightly lower rate in Teruel. Our survey confirms Spain as a high-risk area for MS, with prevalence rates over 50 per 100,000.
Subject(s)
Multiple Sclerosis/epidemiology , Adolescent , Adult , Age Distribution , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Multiple Sclerosis/diagnosis , Sex Distribution , Spain/epidemiologyABSTRACT
INTRODUCTION: Fatigue is one of the commonest findings in multiple sclerosis (MS) although it has scarcely been investigated as an independent symptom. OBJECTIVE: To evaluate the effect of fatigue in a population based series of patients with MS and to analyze its relation to other clinical variables. METHODS: A descriptive, transverse study based on a geographically defined population. Fatigue was measured using the Krupp scale in 48 patients with definite clinical MS. We analyzed the relation between the degree of fatigue and sex, age of onset, age at the time of the study, type of evolution, index of progression of disability, duration of illness and degree of impairment according to the Expanded Disability Status Scale (EDSS) and neurological functional systems. RESULTS: 64.6% of the patients had a significant degree of fatigue. Of these, 90% considered fatigue to be one of the three most disabling symptoms of their illness. There was no difference between men and women in their perception of fatigue. The patients with progressive illness, of greater age and those with higher EDSS scores had more fatigue. This aspect was not affected by age of onset, duration of illness nor index of progression. CONCLUSIONS: Fatigue should be evaluated as an independent symptom of MS. Evaluation using specific scales may contribute to better understanding of the physiopathology and investigation of more effective treatment.
Subject(s)
Fatigue/epidemiology , Multiple Sclerosis/complications , Adolescent , Adult , Age of Onset , Cross-Sectional Studies , Disability Evaluation , Disease Progression , Fatigue/etiology , Fatigue/psychology , Female , Humans , Male , Middle Aged , Multiple Sclerosis/epidemiology , Severity of Illness Index , Spain/epidemiologyABSTRACT
INTRODUCTION: Apart from impairment there is hardly any other assessment of the repercussions of multiple sclerosis (MS) in population studies. OBJECTIVE: To analyze the functional state of en epidemiological series of patients in the Valladolid health district. MATERIAL AND METHODS: A descriptive transversal study of a geographically defined population base. During a period of three months and complementing a prevalence study, were assessed, by means of the Minimal Record of Disability, impairment, disability and handicap in a series of 51 patients (33 women and 18 men) with clinically defined MS, who lived in the area on 1 March 1997. RESULTS: There was a primarily progressive evolution in 21.6% of the patients, and secondarily progressive in 11.8%. Average follow-up time was 9.1 years (range 1-41) and average age of onset 27.8 years (range 14.7-51.0). The distribution of scores on the Expanded Disability Status Scale was bimodal (average and interquartile range: 3.0 (1.5-5.0). 80.4% of the patients continued to be ambulatory. 21.5% had frequent urinary incontinence or required a long-term urinary catheter. Less than 20% needed help with day to day activities. 78% of the patients complained of some degree of fatigue, and 51% had difficulties with social relationships. 59.4% of the patients had full-time jobs and 70.6% had no financial problems. CONCLUSIONS: The study shows that the functional state of persons with MS is better than was thought, and that assessment of the consequences of this illness should include disability and handicap profiles.
