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  • 1
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 8, No. 6 ( 1997), p. 359-365
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1997
    detail.hit.zdb_id: 1482186-2
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  • 2
    In: Neuroepidemiology, S. Karger AG, Vol. 54, No. 2 ( 2020), p. 123-130
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Multiple sclerosis (MS) is the most common chronic neurologic disease of young adults, placing a heavy burden on patients, families, and the healthcare system. Ongoing surveillance of the incidence and prevalence of MS is critical for health policy and research, but feasible options are limited in the United States and many other countries. We investigated the feasibility of monitoring the prevalence of MS using a large national telephone survey of the adult US population. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We developed questions to estimate the lifetime prevalence and age of onset of MS using the US-based Behavioral Risk Factor Surveillance System (BRFSS) and piloted these questions in 4 states (MN, RI, MD, and TX). There was a total of 45,198 respondents aged 18 years and above. Analyses investigated individual state and combined prevalence estimates along with health-related comorbidities and limitations. MS prevalence estimates from the BRFSS were compared to estimates from multi-source administrative claims and traditional population-based methods. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The estimated lifetime prevalence of self-reported MS (per 100,000 adults) was 682 (95% CI 528–836); 384 (95% CI 239–529) among males and 957 (95% CI 694–1,220) among females. Estimates were consistent across the 4 states but much higher than recently published estimates using population-based administrative claims data. This was observed for both national results and for MS prevalence estimates from other studies within specific states (MN, RI, and TX). Prevalence estimates for Caucasian, African American, and Hispanic respondents were 824, 741, and 349 per 100,000 respectively. Age and sex distributions were consistent with prior epidemiologic reports. Comorbidity and functional limitations were more pronounced among female than male respondents. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 While yielding higher overall MS prevalence estimates compared to recent studies, this large-scale self-report telephone method yielded relative prevalence estimates (e.g., prevalence patterns of MS by sex, age, and race-ethnicity) that were generally comparable to other surveillance approaches. With certain caveats, population-based telephone surveys may eventually offer the ability to investigate novel disease correlates and are relatively feasible, and affordable. Further work is needed to create a valid question set and methodology for case ascertainment before this approach could be adopted to accurately estimate MS prevalence.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1483032-2
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  • 3
    In: Neuroepidemiology, S. Karger AG, Vol. 34, No. 4 ( 2010), p. 238-244
    Abstract: 〈 i 〉 Backgrounds/Aim: 〈 /i 〉 Gestational and early life events have been suggested to contribute to multiple sclerosis (MS) susceptibility. We assessed the effects of time and place of birth on the age at onset of MS symptoms. 〈 i 〉 Methods: 〈 /i 〉 We selected a national cohort of 967 veterans from the Multiple Sclerosis Surveillance Registry for whom month and season (time) of birth, and birthplace (city and state) were available. Multiple linear regression analyses were used to examine the association between time of birth, birthplace latitude and solar radiation, and the age at onset of MS symptoms among the study sample. 〈 i 〉 Results: 〈 /i 〉 Patients with a relapsing form of the disease (R-MS), who were born in winter and whose birthplace was in low solar radiation areas, had disease symptom onset on average 2.8 years earlier than those born in seasons other than winter and in medium- and high-solar radiation areas (p = 0.02). 〈 i 〉 Conclusions: 〈 /i 〉 These results suggest that exposure early in life to geographical and seasonal factors, possibly related to the protective effect of sunlight, and thus vitamin D, is associated with a delay in MS symptom onset. Other larger studies are required to examine the period-specific (from conception to adulthood) environmental factors that are associated with MS susceptibility.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1483032-2
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  • 4
    In: Neuroepidemiology, S. Karger AG, Vol. 37, No. 1 ( 2011), p. 52-57
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Early life events have been suggested to influence multiple sclerosis (MS) susceptibility, and to potentially modulate its clinical course. We assessed vitamin D-related exposures from childhood to disease onset and their associations with MS progression. 〈 i 〉 Methods: 〈 /i 〉 Among veterans in the Multiple Sclerosis Surveillance Registry, 219 reported having the progressive form and met the inclusion criteria. Participants reported their past sun exposure, vitamin D-related intake and age at disability milestones using the Patient-Determined Disease Steps (PDDS). The Cox proportional hazards model was used to examine the association between vitamin D-related exposures and time (years) to disability. 〈 i 〉 Results: 〈 /i 〉 Low average sun exposure in the fall/winter before disease onset was associated with an increased risk of progressing to a PDDS score of 8 (hazard ratio, HR: 2.13, 95% confidence interval, CI: 1.20–3.78), whereas use of cod liver oil during childhood and adolescence was associated with a reduced risk (HR: 0.44, 95% CI: 0.20–0.96). 〈 i 〉 Conclusions: 〈 /i 〉 These results suggest that exposure to vitamin D before MS onset might slow disease-related neurodegeneration and thus delay progression to disability among patients with the progressive subtype.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1483032-2
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  • 5
    In: Neuroepidemiology, S. Karger AG, Vol. 42, No. 4 ( 2014), p. 226-234
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Concern has been raised that US veterans of the 1990-1991 Gulf War (GW1) may be at increased risk to develop neurologic disease. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 An incident cohort of multiple sclerosis (MS) and other demyelinating disease (ODD) was assembled from the US military comprising the Gulf War era (1990-2007). Cases of MS and ODD meeting standard diagnostic criteria were matched to a database of all active duty personnel from the Department of Defense. Relative risk (RR) estimates for MS and all demyelinating disease based on onset, deployment status, and exposures were calculated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 For GW1, a total of 1,841 incident cases of definite MS and ODD were identified, with 387 among 696,118 deployed and 1,454 among 1,786,215 nondeployed personnel. The RR for MS alone among those deployed compared to those nondeployed was 0.69 (confidence interval, CI: 0.61-0.78), with 0.72 (CI: 0.62-0.83) in men and 0.96 (CI: 0.75-1.22) in women. Deployment was also nonsignificant or protective as an MS risk factor across racial groups, all age groups, and each military service. RRs for MS by service were: Air Force 0.71 (CI: 0.53-0.96), Army 0.80 (CI: 0.67-0.96), Marines 0.96 (CI: 0.63-1.47), and Navy 0.56 (CI: 0.43-0.74). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Military deployment to GW1 was not a risk factor for developing MS.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1483032-2
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  • 6
    In: Neuroepidemiology, S. Karger AG, Vol. 36, No. 1 ( 2011), p. 39-45
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Current evidence suggests that sun exposure and vitamin D intake, during childhood and adolescence, are associated with a reduced risk of multiple sclerosis (MS). However, the role of these environmental agents in the timing of disease symptom onset remains to be investigated. 〈 i 〉 Methods: 〈 /i 〉 Using a cross-sectional study design, we recruited participants from the Veterans Health Administration – Multiple Sclerosis Surveillance Registry. Self-reported histories of residential locations, sun exposure and intake of vitamin D were used to estimate vitamin-D-related exposures. Multivariable linear regression analysis was used to examine the associations between these variables and age at MS onset. 〈 i 〉 Results: 〈 /i 〉 Among veterans with relapsing MS who resided in low-to-medium solar radiation areas (n = 540), low sun exposure in the fall/winter during the ages of 6–15 years was significantly associated with earlier symptom onset by 2.1 years (p = 0.02). Intake of cod liver oil during the same age period was associated with later onset of MS symptoms by 4 years (p = 0.02). 〈 i 〉 Conclusions: 〈 /i 〉 The current study provides evidence for an association between vitamin-D-related exposures during childhood and early adolescence and the timing of MS symptom onset, and supports vitamin D as a potential modulator of the clinical course of this disease.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1483032-2
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