Background: Many factors are associated with aging on multiple sclerosis progression. We assess associations of neighborhood resources and race with outcomes in aging people with multiple sclerosis (PwMS). Purpose: We evaluated if worsening outcomes differed by neighborhood resources and race for PwMS age >55. Methods: A longitudinal cohort study of 1456 PwMS (mean age 61.7 (standard deviation (SD): 5.5), 73% female, 87% White race) was conducted at tertiary MS centers between 2015 and 2021 with 3–5 years of follow-up. Predictors included area deprivation index (ADI) and race. Outcomes included 10 Neuro-QoL domains and three performance measures: manual dexterity test (MDT dominant hand), walking speed test (WST), and processing speed test (PST), with worsening defined using clinically meaningful changes. Results: In adjusted models, greater ADI (i.e. fewer resources) was associated with worsening MDT and WST (odds ratio (95% confidence interval (CI)) = 1.12 (1.05–1.19), 1.09 (1.02–1.16), respectively), and with worsening on Neuro-QoL domains of social roles, stigma, and fatigue. Patients of Black race had less worsening on social roles and depression, compared to patients of White race. Conclusion: Our study demonstrated an association between fewer neighborhood resources and worsening performance measures and self-reported outcomes. This study demonstrates that neighborhood deprivation, but less likely race, may play a role in worsening for PwMS >55 years.
Miller et al. (Mon,) studied this question.