Self-reported levels of education and disability progression in multiple sclerosis

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OBJECTIVES: The purpose of our study is to investigate whether socioeconomic indicators such as education, financial concerns, employment, and living status are associated with disease progression in relapsing-onset and progressive-onset Multiple Sclerosis (MS).

MATERIALS AND METHODS: We performed a cross-sectional survey among individuals with MS, registered by the Flemish MS society and included socioeconomic indicators. A Cox proportional hazard regression was performed with the time from MS onset and from birth to reach an ambulatory disability milestone corresponding to Expanded Disability Status Scale (EDSS) 6 (requiring a cane) as outcome measure, adjusted for gender, age at MS onset, and immunomodulatory treatment.

RESULTS: Among the participants with relapsing-onset MS, subjects reporting education for more than 12 years had a reduced risk of reaching EDSS 6 compared to subjects reporting education for less than 12 years [HR from onset 0.68 (95% CI 0.49-0.95); HR from birth 0.71 (95% CI 0.51-0.99)]. In progressive-onset MS, longer education was associated with an increased hazard to reach EDSS 6 [HR from onset 1.25 (95% CI 0.91-1.70); HR from birth 1.39 (95% CI 1.02-1.90)].

CONCLUSIONS: Our study shows an association of self-reported levels of education with disability progression in MS, with the highest level being protective in relapsing-onset MS.

Original languageEnglish
Pages (from-to)414-419
Number of pages6
JournalActa Neurologica Scandinavica
Issue number6
Publication statusPublished - Dec 2016


  • Adolescent
  • Adult
  • Age Factors
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Belgium
  • Cross-Sectional Studies
  • Disability Evaluation
  • Disease Progression
  • Educational Status
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis
  • Multiple Sclerosis, Relapsing-Remitting
  • Self Report
  • Sex Factors
  • Young Adult


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