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Two populations with multiple sclerosis

Clinical and demographic characteristics

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Summary

Cross-sectional data from 1,793 cases of definite or probable multiple sclerosis (MS) identified in an extensive population survey in King and Pierce (K-P) Counties, Washington and Los Angeles (LA) County, California, were analyzed. Compared to the U.S. population as a whole, patients were more likely to be divorced and to have more years of schooling. The prevalence of MS was higher for females, and for northern-born, regardless of sex. Reconstructed age-, sex-specific incidence rate estimates for natives of the two areas showed a much higher peak annual incidence occurring in an older age group in K-P than in LA. Earliest symptoms in both areas were numbness in the legs, double vision, and loss of vision in one or both eyes. Weakness in arms, speech difficulties, and urinary incontinence tended to be late symptoms. The overall assessment of disability levels showed more than half of the patients to be fully ambulatory at the time of the first interview, with a somewhat higher proportion of each sex severely disabled in California. The ages of onset tended to be younger in LA than in K-P. The earlier onset of disease and the higher proportion of patients with high disability in Los Angeles County suggest that the course of disease is more malignant in this low-prevalence area.

Zusammenfassung

Es wurden Durchschnittsdaten von 1793 Fällen definitiver und wahrscheinlicher Multipler Sklerose (MS) analysiert, die in umfangreichen Bevölkerungserhebungen identifiziert wurden, in den Landkreisen King und Pierce (K-P) in Washington und in dem Landkreis Los Angeles (LA). Verglichen mit der Gesamtbevölkerung der Vereinigten Staaten, waren die Patienten häufiger geschieden und hatten mehr Jahre Schulung. Das Auftreten von MS war häufiger bei weiblichen Personen und bei solchen, die im Norden geboren waren, ungeachtet des Geschlechts. Die Schätzungen der Rate der rekonstruierten alters- und geschlechtsspezifischen Fälle für die Einwohner der zwei Gebiete zeigt einen viel höheren Höchstwert von jährlichem Fallauftreten bei den älteren Altersgruppen in K-P als in LA. Erste Symptome in beiden Gegenden waren Gefühllosigkeit in den Beinen, Doppelsichtigkeit und Verlust des Sehvermögens auf einem oder beiden Augen. Schwäche in den Armen, Sprachschwierigkeiten und Harnfluß waren mehr spätere Symptome. Die Gesamtbewertung der Behinderungsstadien zeigte, daß mehr als die Hälfte der Patienten zur Zeit des ersten Interviews völlig ambulant waren, mit einem etwas höheren Anteil an schwer behinderten bei Personen von beiderlei Geschlecht in Kalifornien. Das Alter bei Beginn neigte in LA jünger zu sein als in K-P. Das frühere Anfangsalter der Krankheit und der höhere Anteil von Patienten mit schwerer Behinderung in dem Landkreis Los Angeles weist auf einen bösartigeren Verlauf in diesem Gebiet mit geringer Verbreitung.

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Supported by Grant 2R01 NS 10186 from the National Institute of Neurologic and Communicative Disorders and Stroke, National Institutes of Health. Computing assistance was obtained from the Hospital Data Processing Facility, University of California, Los Angeles (UCLA)

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Visscher, B.R., Clark, V.A., Detels, R. et al. Two populations with multiple sclerosis. J Neurol 225, 237–249 (1981). https://doi.org/10.1007/BF00313296

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