Abstract Details

Title The impact of socioeconomic status on subsequent neurological outcomes in multiple sclerosis

Topic Multiple Sclerosis

Presentation(s) S40 - MS Diversity and Epidemiology (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Background

In PwMS, lower SES is associated with greater disability and lower quality of life. Few studies have examined the temporal relationship between neighborhood- or individual-level SES and neurological disability in PwMS using clinically relevant patient-reported outcomes (PROs).

Objective

Examine whether lower neighborhood-level indicators of socioeconomic status (SES) and individual-level SES are associated with subsequently increased neurological and physical disability in people with MS (PwMS).

Design/Methods Analyzed prospectively collected data from Discovery cohort (University of Pittsburgh, N=1326) and Replication cohort (Columbia University, N=488). Area-level SES used area deprivation index (ADI) based on participants’ residence at enrollment. Individual-level SES was based on participant’s household income. Neurological outcomes measured by Multiple Sclerosis Rating Scale–Revised (MSRS-R), Patient-Determined Disease Steps (PDDS), and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function scores from 2018 to 2020. We performed regression analyses and adjusted for age, sex, race/ethnicity, disease duration, age at symptom onset, and disease modifying therapy. Meta-analyses used random effects models.

Results Higher ADI (lower SES) in 2015 was associated with worse neurological outcomes in 2018 to 2020 (discovery: MSRS-R, β=0.63, 95%CI 0.36-0.89, p<0.001; PDDS, β=0.11, 95%CI 0.02-0.20, p=0.018 | replication: MSRS-R, β=0.39, 95%CI 0.14-0.64, p=0.003; PDDS, β=0.11, 95%CI 0.02-0.20, p=0.015). Increase in neighborhood-level median household income, a key driver of SES, from 2015 to 2018 was associated with better neurological outcomes in 2020 (Joint-analysis: MSRS-R, β=-0.04, 95%CI -0.07-0.00, p=0.025; PDDS, β=-0.02, 95%CI -0.03 - -0.00, p=0.004; PROMIS, β=0.08, 95%CI 0.01-0.15, p=0.017). Higher individual-level household income bracket was associated with better neurological outcomes (MSRS-R: R=-0.39, p<0.001; PDDS: R=-0.35, p<0.001; PROMIS: R=0.37, p<0.001), independent of ADI.

Conclusions Lower SES at neighborhood level is associated with subsequently worse neurological outcomes in PwMS, while improvement in neighborhood SES was associated with subsequently better outcomes.

Authors/Disclosures
Devi Sai Sri Kavya Boorgu PRESENTER	Ms. Boorgu has received research support from University of Pittsburgh School of Medicine.
Shruthi Venkatesh	Miss Venkatesh has received research support from NIH.
	No disclosure on file
	No disclosure on file
Claire Riley, MD, FAAN (Columbia University Medical Center)	Dr. Riley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Viracta. Dr. Riley 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.
	No disclosure on file
Philip De Jager, MD, PhD (Columbia University Irving Medical Center)	Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. De Jager has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Puretech. Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for roche. Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. The institution of Dr. De Jager has received research support from roche. The institution of Dr. De Jager has received research support from Biogen. The institution of Dr. De Jager has received research support from puretech.
Zongqi Xia, MD, PhD	Dr. Xia has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Xia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. The institution of Dr. Xia has received research support from National Institute of Health. The institution of Dr. Xia has received research support from Octave Biosciences. The institution of Dr. Xia has received research support from Department of Defense. The institution of Dr. Xia has received research support from Genentech/Roche.