Disability and prognosis in multiple sclerosis: demographic and clinical variables important for the ability to walk and awarding of disability pension

Objective: To evaluate disability and prognosis in on untreated population- based incidence cohort of multiple sclerosis (MS) patients. Methods: The Ex panded Disability Status Scale (EDSS) score was recorded in 220 MS patients . Disease progression was assessed by life table analysis with different en dpoints and multivariate Cox regression analysis was performed for evaluati on of prognostic factors. Results: The probability of being olive after 15 years was 94.8 +/-1.8% (s.e.), of managing without a wheelchair (EDSS < 7.0 ) 75.8<plus/minus>3.2%, of walking without walking assistance (EDSS<6.0) 60 .3<plus/minus>3.6%, and of not being awarded a disability pension 46.0 +/-3 .7%. The probability of still having a relapsing-remitting (RR) course afte r Is years was 62.0 +/-4.1%. A RR course and long interval between the init ial (onset) and second episode (>3 years) predicted favorable outcome. Ther e was also a trend towards favorable outcome in patients with optic neuriti s, sensory symptoms and low age at onset but these factors were associated with the RR course. Motor symptoms and high age at onset indicated unfavora ble outcome, but these factors were associated with the primary Progressive course. Conclusions: A RR course and long inter-episode intervals in the e arly phase of the disease were associated with a better outcome. Other onse t characteristics indicating a favorable outcome were associated with the R R course while characteristics indicating on unfavorable outcome were assoc iated with the PP course.