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Belvisi D, Canevelli M, Baione V, Buscarinu MC, Pellicciari G, Fantozzi R, Creta A, Cecchi G, Cola G, Nicoletti CG, Cortese A, De Giglio L, Tartaglia M, Crisafulli SG, Bruno G, Ferraro E, Marfia GA, Centonze D, Salvetti M, Conte A. Operationalization of a frailty index in patients with multiple sclerosis: A cross-sectional investigation. Mult Scler 2021; 27:1939-1947. [PMID: 33565913 DOI: 10.1177/1352458520987541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Frailty is an age-related status of increased vulnerability to stressors caused by the accumulation of multiple health deficits. This construct may allow to capture the clinical complexity of patients with multiple sclerosis (MS). OBJECTIVE To investigate the relationship between frailty and the clinical manifestations of MS. METHODS Patients with MS were consecutively enrolled at five tertiary dedicated services. Disability and fatigue were assessed. The phenotypes of MS were also identified. Frailty was measured using a frailty index (FI), computed by cumulatively considering 42 age-related multidimensional health deficits. RESULTS Overall, 745 MS patients (mean age = 48.2 years, standard deviation = 11.7 years; women 68%) were considered. The median FI value was 0.12 (interquartile range = 0.05-0.19) and the 99th percentile was 0.40. FI scores were associated with MS disease duration, disability, fatigue, as well as with the number of previous disease-modifying treatments and current symptomatic therapies. A logistic regression analysis model showed that FI score was independently associated with the secondary progressive phenotype. CONCLUSION Frailty is significantly associated with major characteristics of MS. The findings of the present cross-sectional investigation should be explored in future longitudinal studies.
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Affiliation(s)
- Daniele Belvisi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy/IRCCS Neuromed, Pozzilli, Italy
| | - Marco Canevelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy/National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | - Viola Baione
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Maria Chiara Buscarinu
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Giulia Pellicciari
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | | | | | - Gianluca Cecchi
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Gaia Cola
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Carolina Gabri Nicoletti
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | | | | - Matteo Tartaglia
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Giuseppe Bruno
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Girolama Alessandra Marfia
- IRCCS Neuromed, Pozzilli, Italy/Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Diego Centonze
- IRCCS Neuromed, Pozzilli, Italy/Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Marco Salvetti
- IRCCS Neuromed, Pozzilli, Italy/Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Antonella Conte
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy/IRCCS Neuromed, Pozzilli, Italy
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