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Departments of Neurology (Drs. Rodriguez and Siva), Health Sciences Research (Clinical Epidemiology and Biostatistics) (Drs. Siva, O'Brien, and Kurland, and J. Ward), and Physical Medicine and Rehabilitation (K. Stolp-Smith), Mayo Clinic/Foundation, Rochester, MN.
We studied functional status of MS patients in a geographically based cohort in Olmsted County, Minnesota. The 162 definite MS patients who were alive and residing in the study area on December 1, 1991, constituted the MS prevalence disability cohort. We identified 179 cases of definite or probable MS, providing an overall sex-and age-adjusted prevalence rate of 167.5 per 100,000. Median duration of MS from onset was 15.4 years, and median age on prevalence date was 47.5 years. The Minimal Record of Disability for MS determined the degree of impairment, disability, and handicap of the entire cohort within 4 months of the prevalence date. The frequency of Expanded Disability Status Scale scores of the MS prevalence cohort showed a bimodal distribution with peaks at 1 and 6.5 (3.5 [1 to 9.5], median [range]). Approximately one-third of the cohort had marked paraparesis, paraplegia, or quadriplegia. One-fourth of all patients needed intermittent or almost constant catheterization for bladder dysfunction. Few patients (3.7%) reported severe decrease in mentation or dementia requiring supervision. Many patients (53.1%) were working full-time. Most patients (72.2%) maintained their usual financial standard without external support. There were no differences in level of impairment, disability, or handicap observed between the subgroup of 122 patients (75.3%) who are incident cases (onset of disease as residents of Olmsted County) compared with the entire prevalence cohort. This geographically based study of MS demonstrates that the functional status is more favorable than previously recognized.
Address correspondence and reprint requests to Dr. Moses Rodriguez, Mayo Clinic/Foundation, Department of Neurology, Rochester, MN 55905.
Dr. Siva conducted this research while he was a visiting scientist; he is currently an Associate Professor, Neurology Department, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
Received April 1, 1993. Accepted for publication in final form June 14, 1993.
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