Baseline physical and cognitive functions associate with the longitudinal trajectory of stigma in patients with multiple sclerosis (MS)

Abstract

Background

Multiple sclerosis is a chronic disease, and the lived experience of a person with MS is highly heterogeneous.

Objective

To analyze longitudinal trajectories of stigma in MS, the associated baseline predictors, and how the stigma trajectories relate to the longitudinal changes in physical disability.

Method

In a cohort of people from the MS Partners Advancing Technology and Health Solutions (MS PATHS) network with at least two stigma measures, we analyzed the trajectory of stigma and physical disability by applying a group-based trajectory modeling (GBTM) to longitudinal measures of Neuro-QoL stigma T-score and Patient Determined Disease Steps (PDDS), respectively.

Results

We included 8,404 MS PATHS participants with a mean follow-up duration of 2.8 ± 1.4 years. We found four stigma trajectories, which remained stable over the follow-up period. Compared to the no stigma trajectory group, the odds of being in the high stigma group were higher in people with higher baseline PDDS (OR=1.9, 95 % CI: 1.7–2.1) and stigma (OR=2.4, 95 % CI: 2.3–2.5), and worse processing speed test scores (OR=0.7, 95 % CI: 0.6–0.8). The trajectory of stigma was strongly associated with the PDDS trajectory.

Conclusions

Baseline severity of stigma, physical disability, and performance on the processing speed test were the strongest predictors of belonging to a higher stigma trajectory group.