The Effect of Modifiable Risk Factors on Multiple Sclerosis Progression

Background: Smoking, alcohol intake and vitamin D deficiency are prevalent in patients with MS contributing to MS progression requiring clinical and research implications.

Objectives: To evaluate the association between modifiable risk factors (smoking, alcohol consumption and vitamin D deficiency) and multiple sclerosis (MS) progression as measured by the Expanded Disability Status Scale (EDSS), magnetic resonance imaging (MRI) new lesions, relapse rate, and the Timed 25 Foot Walk (T25FW).

Methods: Subjects (n=150) were identified through age, gender, race, and disease duration and followed retrospectively for 5 years based on medical records. Descriptive statistics, correlation, logistic and linear regression analyses were performed to determine the association between modifiable risk factors and MS progression.

Results: The mean age was 45.5 years (SD 14.3), 79 % were females and 59% were Non-Hispanic Whites, 70% had more than 5 years duration of disease, 68% were never smokers, 58% were social drinkers, 51% had low vitamin D level (<30), and 77% had relapsing-remitting MS (RRMS). Current smokers had 5 times greater odds to have increased disability than never smokers (p=.03). Alcohol drinkers based on number of drinks had (-.172) times the odds of having increased disability; thus having a greater odds of reaching lower EDSS scores. There was no association between vitamin D levels and disease progression in MS. 

Conclusions: Smoking and alcohol intake are associated with MS. Smoking has a detrimental effect and alcohol consumption has a neuroprotective effect in MS. Vitamin D has not shown any statistical significant results. Assessment and addressing modifiable risk factors in MS aid in minimizing the progression of the disease.