Social disparities and racism might lead to differences in disability outcomes in African American vs. White multiple sclerosis patients.
Multiple sclerosis (MS) displays a more aggressive disease course in African American than in White people. Sociodemographic factors might contribute to differences in disability outcomes between the two groups by limiting access to healthcare or influencing lifestyle behaviors. However, the factors behind the differences in disease burden between African American and White people with MS remain unclear. A study published in the journal Multiple Sclerosis and Related Disorders explored whether race contributes to the differences in disability outcomes in MS patients.
This cross-sectional study comprised 120 patients with MS and 82 healthy controls self-identified as African American or White. Patients ranged from 18 to 70 years of age. Duration from disease onset was within six years for all participants.
Outcomes of Interest
- global disability, measured by the Expanded Disability Status Scale (EDSS)
- mobility and leg function, quantitatively assessed by the Timed 25 Foot Walk Test (T25FWT)
- quantitative finger dexterity, measured by the 9-Hole Peg Test (9HPT)
- cognitive efficiency and speed, tested through the Symbol Digit Modalities Test (SDMT)
Disparities in Disability Severity Among MS Patients Based on Race
African American MS patients performed significantly worse in manual dexterity and cognition than White MS patients. MS and race contributed independently to the observed gradient in the severity of the disability.
Correlation Between Race and Other Parameters
No correlation was found between race and the Expanded Disability Status Scale (EDSS) or the Timed 25 Foot Walk Test (T25FWT) scores.
Cognitive and Motor Function Impairments in MS Patients
MS patients scored significantly higher on 9HPT than healthy controls, with African Americans having worse scores than White patients. MS patients scored significantly lower on SDMT than healthy controls, with African Americans performing worse than White patients.
These findings suggest a difference in fine motor performance and cognitive efficiency at an early disease stage between African American and White patients with MS, even after controlling for comorbidities and socioeconomic confounders. Future research concerning minorities and disadvantaged ethnic groups needs to elucidate the effects of systemic racism and socioeconomic disparities on disease course and disability in MS.
Petracca, M., Palladino, R., Droby, A., Kurz, D., Graziano, N. B. S. J., Wang, K., Riley, C. S., Howard, J., Klineova, S., Lublin, F., & Inglese, M. (2023). Disability outcomes in early-stage African American and White people with multiple sclerosis. Multiple Sclerosis and Related Disorders, 69, 104413. https://doi.org/10.1016/j.msard.2022.104413