Objective:

To describe the incidence of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in persons with multiple sclerosis (PwMS).

Background:

Design/Methods:

This retrospective study identified newly diagnosed PwMS aged ≥18 at index date, with ≥12 months follow-up in the Komodo Health Claims Database (1/1/17–5/1/23). Index date was the date of first MS diagnosis based on ICD-10 code G35. Patients with any MS DMT use prior to index date were excluded. Data were gathered on percentage of patients with AD or MCI following MS diagnosis, and percentage of PwMS with MCI diagnosis converting to AD. Analyses of patient demographics and clinical characteristics in PwMS at MCI and AD diagnosis were conducted and further stratified by race/ethnicity.

Results:

This study included 193,885 PwMS (Asian, n=3,128; Black, n=24,282; Hispanic, n=17,560; White, n=108,141). In the overall MS population (follow-up from MS diagnosis, 3.6 years), 8,748 (4.5%) patients had MCI and 2,569 (1.3%) had a diagnosis of AD. Of the patients with MCI, 407 (4.7%) converted to AD. At MCI diagnosis, Asian/Black/Hispanic PwMS were aged 52.2/52.6/52.2 vs 56.4 White [p<0.001], respectively, with Charlson comorbidity index (CCI) 1.39/1.35/1.54 vs 0.98 White (p<0.001 for Hispanic and Black). At AD diagnosis, Asian/Black/Hispanic PwMS were aged 66.5/66.0/68.4 vs 69.5 White (p<0.001 Black vs White), with CCI 3.53/2.32/2.90 vs 1.70 White (p<0.001).

Conclusions:

A low incidence of MCI and AD were observed in the cohort of PwMS studied. Asian/Black/Hispanic patients were younger with higher CCI than White PwMS at MCI diagnosis. Black PwMS were younger than White at AD diagnosis and Asian/Black/Hispanic had higher CCI than White PwMS at AD diagnosis.

Sponsorship: Biogen