Progression of disability in XXXX : A study of factors influencing median time to reach an EDSS value.

@entity1 @entity32 @entity22025 @entity24240 @entity807 @entity15
BACKGROUND: The extended disability severity scale (EDSS) is clinically useful in assessing disability in @entity15 ( @entity15 ) @entity1 . It is also being used in studies to determine how genes and environment influence disability. However, since it has a complex relationship with functional scores and mobility and is strongly determined by disease duration its use can be limiting. OBJECTIVE: Study associations of variables with progression described by time from disease onset until EDSS. METHODS: We used a variable based on below/above median time from @entity15 onset to reach a single EDSS value to define slow or fast progression. We compared @entity1 categorization using this variable and MSSS, and in 533 @entity1 (EDSS 1-8) and 242 of these @entity1 with @entity807 -4, studied associations with skin type, gender, ultraviolet radiation and @entity22025 @entity24240 . RESULTS: Classifying @entity1 into quartiles of slow/fast progression showed mean MSSS increased with faster progression (p<0.001). For EDSS 1-8: MSSS, late onset age and childhood sunburning were associated with fast and @entity22025 CG/GG(294) with slow progression. Combinations of skin type (1/2 or 3/4) with childhood weekend exposure (< or >= median) or sunburning (yes/no) were not associated with progression. However, in @entity1 with @entity807 -4, relative to other combinations, those with no sunburning history and types 1/2 demonstrated slow progression (odds ratio=0.15, 95% CI=0.04, 0.57). CONCLUSION: This method, though a pilot, allows study of associations of variables with EDSS. It is based on local @entity1 and could substitute for MSSS. In @entity1 with @entity807 -4 but not 1-8, skin type 1/2 with no history of childhood sunburning was associated with slow progression. This is compatible with the view that disability develops through a first stage dependent on @entity32 .
