Baseline Physical and Cognitive Function Are Associated with the Longitudinal Trajectory of Stigma in Multiple Sclerosis
Mahsa Ghajarzadeh1, Kathryn C Fitzgerald1, Ellen Mowry2, Yishang Huang1, Bardia Nourbakhsh2
1johns hopkins, 2Johns Hopkins University
Objective:
To analyze the longitudinal trajectory of stigma in MS, the associated baseline factors, and how the trajectory of stigma relates to the longitudinal trajectory of physical disability.
Background:
MS is a chronic disease, and how it affects an individual can evolve over time. Stigma is common among people with MS, but its trajectory throughout the disease course is unclear.
Design/Methods:
In a cohort of people from the MS Partners Advancing Technology and Health Solutions (MS PATHS)( MS PATHS is sponsored by Biogen, Inc. (Cambridge, MA)) network, we analyzed the trajectory of stigma and physical disability by applying a group-based trajectory modeling (GBTM) to longitudinal measures of Neuro-QoL stigma T-score and Patient Determined Disease Steps (PDDS), respectively. We used joint trajectory models to analyze which participants in a particular stigma trajectory group belonged to a specific PDDS trajectory group and used a multinomial logistic regression model to analyze which baseline demographic or disease-related factors influenced membership in a specific stigma trajectory group
Results:
We included 8,404 MS PATHS participants with a mean follow-up duration of 2.8 ±1.4 years. We identified four trajectories of stigma: no stigma (mean starting score=39.2; 35.2% of the cohort), mild stigma (46.8; 22.6%), moderate stigma (51.8; 29.6%), and severe stigma (58.9; 12.6%). Compared to the no stigma trajectory group, the odds of being in the high stigma group were higher in people with higher baseline PDDS (OR=1.9,95%CI:1.7-2.1) and stigma (OR=2.4,95%CI:2.3-2.5), and worse processing speed test scores (OR=0.68). The trajectory of stigma was strongly associated with the PDDS trajectory.
Conclusions:
In this longitudinal cohort of people with MS, stigma severity remained mostly stable during follow-up. Baseline severity of stigma, physical disability, and performance on the processing speed test were the strongest predictors of belonging to a higher stigma trajectory group.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.