Cohabitation Is Associated with Lower Levels of Clinical Disability in MS

Background: The protective effects of social support have been well documented in other diseases such as cancer, where married patients had a longer mean survival time than those who were single. In MS, most social support studies have been limited to quality of life. Supportive assistance for MS patients is often provided by a spouse or partner. 

Objectives: To investigate if there were any differences in disability measures between MS patients living alone compared to those living with a spouse or partner.

Methods: A total of 4,371 MS patients between the age of 25 and 50 were extracted from the NYSMSC registry. Of those, 726 (16.6%) lived alone, while 3,645 (83.4%) lived with a spouse or partner. ANOVA analysis was conducted to investigate the association of living status with timed-25 foot walk (T25FW) and expanded disability status scale (EDSS). An interaction term with gender was added to explore male and female specific effects. 

Results: The mean age in our sample was 39.6 (6.3) and 3,194 (73.1%) were female. MS patients living alone had significantly higher EDSS scores (3.6±2.3) compared to those living with a significant other (2.9±2.0, p<.001). The time to complete the T25FW was also significantly longer for those living alone (30.0±58.2 vs 18.4±43.5, p<.001). The gender by living status interaction term was significant for both EDSS (p=.012) and T25FW (p=.002). Males living alone had an EDSS of 4.1 (2.4) compared to cohabitating males of 3.1 (2.0) while female MS patients living alone had a mean EDSS of 3.4 (2.1) compared to 2.8 (2.0) for those living together. Male MS patients living alone had a mean T25FW time of 39.1 seconds (66.8), more than twice as long as males who lived with a spouse or partner (18.2±43.3), a result that was less notable in females (26.0±53.5 living alone vs 18.5±43.7 living together).

Conclusions: MS patients living alone had significantly higher EDSS scores, and took a longer time to complete the T25FW ambulation test compared to those living together. Social support, often provided by a partner, has been found to be associated with increased medication adherence and psychological wellbeing. Results stratified by sex showed that males living alone experienced worse levels of disability than females living alone. Studies have shown that women generally have larger social networks and may therefore rely less on caregiver support than men.