Heleen Beckerman, Jiska C. E. Kempen, Dirk L. Knol, Chris H. Polman, Gustaaf J. Lankhorst, Vincent de Groot
Department of Rehabilitation Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, NL-1007 MB Amsterdam, The Netherlands. E-mail: h.beckerman@vumc.nl
DOI: 10.2340/16501977-1079

Objective: To determine the course of daily functioning in patients with multiple sclerosis in the 10 years after their definite diagnosis.
Methods: A long-term prospective follow-up study including an incidence cohort of 156 patients with multiple sclerosis. Participants were examined systematically, beginning immediately after definite diagnosis, then at the following time-points: 6 months, 1, 2, 3, 6 and 10 years. The various domains of daily functioning were assessed with the Expanded Disability Status Scale, the Functional Independence Measure, and the Medical Outcome Study Short Form-36 (SF-36).
Results: Neurological disability and physical functioning worsened significantly, with a time course dependent on whether a patient had multiple sclerosis of the relapse onset type or non-relapse onset type. Cognitive and social functioning worsened significantly over time, but with the same (accelerated) rate of change in both the RO and NRO groups. Scores on SF-36 mental health, SF-36 role physical, and SF-36 general health changed only slightly.
Conclusion: In the first 10 years after definite diagnosis, patients with multiple sclerosis showed a more pronounced decline in physical functioning than in cognitive and social functioning. There was no time-related decline in mental health, social role due to physical limitations, or general health.