Abstract Details

Title Association of Socioeconomic Disadvantage and Neighborhood Disparities with Clinical Outcomes in Progressive Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) S40 - MS Diversity and Epidemiology (3:42 PM-3:54 PM)

Poster/Presentation
Number 002

Background Socioeconomic disadvantage may be an important contributor to MS disability but is not well understood.

Objective Examine the relationship between Area Deprivation Index (ADI), a validated measure of neighborhood-level disadvantage, and clinical measures in progressive multiple sclerosis (MS).

Design/Methods Data were collected between 2015 – 2020 at the Cleveland Clinic (OH, USA). Relationships between MS Performance Test (MSPT) and Quality of Life in Neurological Disorders (Neuro-QoL) scores were assessed across ADI quartiles (Q1: lowest deprivation – Q4 highest deprivation).

Results

A total of 1000 patients (51.5 ± 12.0 years old, 83.4% Caucasian) with 4801 encounters (median: 3; range 2-13) were included. Baseline Manual Dexterity Test (MDT) illustrated particular disparity as patients living in areas of greatest deprivation had MDT scores 2.5 seconds longer than someone living in areas of least deprivation (Q1 30.9 ± 9.0 seconds vs Q4 33.4 ± 8.3, p = 0.018). Baseline Processing Speed Test showed a similar relationship (Q1: 41.6 ± 12.8 correct answers vs Q4: 38.2 ± 12.4, p = 0.008). Walking Speed Test did not differ across quartiles (Q1: 9.7 ± 6.8 seconds vs Q4: 10.4 ± 5.7, p = 0.23). Longitudinal analysis did not reveal incremental worsening on the MSPT measures associated to ADI. At baseline, Neuro-QoL measures showed better functioning and fewer symptoms in patients living in areas of lowest deprivation (Q1) when compared to those living in the most disadvantaged areas (Q4). Longitudinally, Neuro-QoL measures for patients living in highest deprivation areas (Q4) demonstrated less favorable outcomes for all Neuro-QoL measures. Trends were consistent over time for all ADI quartiles (p>0.05 in interaction testing).

Conclusions This study provides evidence for socioeconomic disadvantage as a risk factor for disability accrual in progressive MS and may be targeted to improve care while informing resource allocation.

Authors/Disclosures
Justin Abbatemarco, MD (Cleveland Clinic Foundation) PRESENTER	Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech . Dr. Abbatemarco has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics, Inc.. The institution of Dr. Abbatemarco has received research support from Horizon.
Alise K. Carlson, MD (Cleveland Clinic)	Dr. Carlson has received research support from Biogen (fellowship grant 16696-P-FEL).
Daniel Ontaneda, MD, PhD, FAAN (Cleveland Clinic)	Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech/Roche. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech.
Marisa P. McGinley, DO (Cleveland Clinic)	Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave. Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. McGinley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. The institution of Dr. McGinley has received research support from Novartis. The institution of Dr. McGinley has received research support from Biogen. The institution of Dr. McGinley has received research support from Genentech. The institution of Dr. McGinley has received research support from NIH.
Robert A. Bermel, MD, FAAN (Cleveland Clinic)	Dr. Bermel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi/Genzyme. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Bermel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela Bio. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck Serono. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Astra Zeneca. Dr. Bermel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for LabCorp. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Bermel has received research support from Biogen. The institution of Dr. Bermel has received research support from Roche. The institution of Dr. Bermel has received research support from Novartis. Dr. Bermel has received intellectual property interests from a discovery or technology relating to health care.
Scott Husak	No disclosure on file
	No disclosure on file
	No disclosure on file
Deborah M. Miller, PhD (Cleveland Clinic Foundation)	Dr. Miller has received intellectual property interests from a discovery or technology relating to health care.