Contributions
Abstract: P676
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background: The World Health Organization Disability Assessment Schedule-2.0 (WHODAS) is recommended to estimate the burden of illness across different populations [1].
Objective: To determine disability prevalence, as defined by WHODAS, for participants with MS in the TONiC study.
Methods: We categorised the WHODAS scores, globally (32-item version omitting questions related to work) and by domain, using previously published criteria, as: no problem (0%-4%); mild problem (5%-24%); moderate problem (25%-49%); severe problem (50%-95%); and extreme problem (95%-100%) and examined the distribution of disability between subjects grouped by subtype and EDSS band [2]. Non-parametric analyses of the relationships between disability and different variables were performed with Kruskal-Wallis ANOVA.
Results: 3532 participants were available for analysis. 72% were female, average age 49.5 years. 63% had relapsing remitting (RR), 4% rapidly evolving RR (RE), 10% primary progressive (PP) and 22% secondary progressive (SP) MS. 53% were EDSS 0-4, 36% EDSS 4.5-6.5, 6% EDSS 7.0-7.5, 5% 8.0-9.5. Across the cohort, global WHODAS level was 29.7% for mild, 37.0% for moderate, and 23.2% for severe disability.
Moderate to extreme disability was common; its prevalence by domains was 73.2% for Life activities (LAC), 70.4% for Getting around (GAR), and 59.8% for Participation in society (PSO). Moderate to extreme disability was reported by 47.5% for Understanding and communication (UAC), 44.0% for Getting along with people (GAP) and 37.9% for Self-care (SCA). The prevalence of moderate/severe/extreme disability by domains and severity was LAC=18.9/42.9/11.4%; GAR=18.1/49.2/3.1%; PSO=32.6/26.7/0.5%; UAC=28.2/18.9/0.4%; GAP=24.5/19.2/0.3% and SCA=16.4/20.7/0.8%.
Between different MS subtypes, median global WHODAS scores were significantly different (SP 47, PP 39, RE 34, RR 23; χ2(2) = 543.9, p = 0.0001). Median WHODAS scores showed the expected ranking by EDSS band (χ2(2) = 1101, p = 0.0001). There was no difference in WHODAS by gender.
Conclusions: The WHODAS was developed to assess six different adult life tasks. This large MS population have high levels of disability, particularly for life activities, mobility and participation. Global disability varies by disease subtype.
References: 1. Ustun TB, Chatterji S, Kostanjsek N et al. Bull World Health Organ 2010;88:815-823.
2. Virues-Ortega J, de Pedro-Cuesta J, Seijo-Martınez M et al. BMC Public Health 2011;11:176.
Disclosure: James ECA, Tennant A, Mills RJ, Miele G and Young CA declare no conflicts of interest for this work. The TONiC study was supported by unrestricted grant support from NIHR, MNDA, Walton Neuroscience Charity, Biogen, Genzyme, Merck, Novartis, Roche, Teva.
Abstract: P676
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background: The World Health Organization Disability Assessment Schedule-2.0 (WHODAS) is recommended to estimate the burden of illness across different populations [1].
Objective: To determine disability prevalence, as defined by WHODAS, for participants with MS in the TONiC study.
Methods: We categorised the WHODAS scores, globally (32-item version omitting questions related to work) and by domain, using previously published criteria, as: no problem (0%-4%); mild problem (5%-24%); moderate problem (25%-49%); severe problem (50%-95%); and extreme problem (95%-100%) and examined the distribution of disability between subjects grouped by subtype and EDSS band [2]. Non-parametric analyses of the relationships between disability and different variables were performed with Kruskal-Wallis ANOVA.
Results: 3532 participants were available for analysis. 72% were female, average age 49.5 years. 63% had relapsing remitting (RR), 4% rapidly evolving RR (RE), 10% primary progressive (PP) and 22% secondary progressive (SP) MS. 53% were EDSS 0-4, 36% EDSS 4.5-6.5, 6% EDSS 7.0-7.5, 5% 8.0-9.5. Across the cohort, global WHODAS level was 29.7% for mild, 37.0% for moderate, and 23.2% for severe disability.
Moderate to extreme disability was common; its prevalence by domains was 73.2% for Life activities (LAC), 70.4% for Getting around (GAR), and 59.8% for Participation in society (PSO). Moderate to extreme disability was reported by 47.5% for Understanding and communication (UAC), 44.0% for Getting along with people (GAP) and 37.9% for Self-care (SCA). The prevalence of moderate/severe/extreme disability by domains and severity was LAC=18.9/42.9/11.4%; GAR=18.1/49.2/3.1%; PSO=32.6/26.7/0.5%; UAC=28.2/18.9/0.4%; GAP=24.5/19.2/0.3% and SCA=16.4/20.7/0.8%.
Between different MS subtypes, median global WHODAS scores were significantly different (SP 47, PP 39, RE 34, RR 23; χ2(2) = 543.9, p = 0.0001). Median WHODAS scores showed the expected ranking by EDSS band (χ2(2) = 1101, p = 0.0001). There was no difference in WHODAS by gender.
Conclusions: The WHODAS was developed to assess six different adult life tasks. This large MS population have high levels of disability, particularly for life activities, mobility and participation. Global disability varies by disease subtype.
References: 1. Ustun TB, Chatterji S, Kostanjsek N et al. Bull World Health Organ 2010;88:815-823.
2. Virues-Ortega J, de Pedro-Cuesta J, Seijo-Martınez M et al. BMC Public Health 2011;11:176.
Disclosure: James ECA, Tennant A, Mills RJ, Miele G and Young CA declare no conflicts of interest for this work. The TONiC study was supported by unrestricted grant support from NIHR, MNDA, Walton Neuroscience Charity, Biogen, Genzyme, Merck, Novartis, Roche, Teva.