SNAPSHOT
Figure 4 . Occurrence Rate Of Urinary Tract Infections
No
Yes
100 %
80 %
Participants
60 %
40 %
20 %
0 % 0 1 2 3 4 5 6 7 8
PDDS Score
general population . The decrease in the incidence of the common cold with age may reflect accumulated immunity , social isolation , and increase health monitoring with age . The pattern of increased risk of UTIs with age reflects that seen in the general population . 2 However , people with MS have increased susceptibility to UTIs compared to the general population due to complications of a neurogenic bladder and the use of catheters . 3 , 4
In past issues of NARCOMS Now , we discussed the value of the Patient Determined Disease Steps ( PDDS ), a patient-reported measure of disability in MS , in providing a scale of the impact of disability on activities of daily living and quality of life . Data from the Spring 2023 survey indicates that the risk of common cold infections among NARCOMS participants decreases with a PDDS score greater than 4 ( Figure 3 ). This result may reflect the decrease in common cold infections with age , shown in Figure 2 , or social isolation since the PDDS score gets worse with greater disability in people with MS .
Figure 4 shows the frequency of UTIs in relation to the PDDS score . Data indicates that the incidence of UTIs increases continuously as the PDDS score increases . This increase is , at least in part , due to age , but , as stated above , UTI incidence also increases with increased disability due to increased opportunity for infection in the MS population . 5
Together , these data show that while people with MS incur infections similar to the general population , age and disability can affect infection rate or be altered by infection . A deeper dive into these data may reveal patterns of infection that can serve to anticipate comorbidities and to adjust overall treatments accordingly . In addition , these data may provide some basis for investigating changes in immune function with age and disease .
REFERENCES 1 . Asemota AO , Schneider EB , Mowry EM , Venkatesan A . Common comorbid and secondary conditions leading to hospitalization in multiple sclerosis patients in the United States . Clinical Neurology and Neurosurgery . 2023 ; 232:107851 . 2 . Liyanarachi KV , Solligård E , Mohus RM , Åsvold BO , Rogne T , Damås JK . Incidence , recurring admissions and mortality of severe bacterial infections and sepsis over a 22- year period in the population-based HUNT study . PLoS One . 2022 ; 17 ( 7 ): e0271263 . 3 . Wirth M , Suda KJ , Burns SP , Weaver FM , Collins E , Safdar N , et al . Retrospective cohort study of patient-reported urinary tract infection signs and symptoms among individuals with neurogenic bladder . American Journal of Physical Medicine & Rehabilitation . 2023 ; 102 ( 8 ). 4 . Medeiros Junior WLGd , Demore CC , Mazaro LP , de Souza MFN , Parolin LF , Melo LH , et al . Urinary tract infection in patients with multiple sclerosis : An overview . Multiple Sclerosis and Related Disorders . 2020 ; 46 . 5 . Li V , Barker N , Curtis C , Porter B , Panicker JN , Chataway J , et al . The prevention and management of hospital admissions for urinary tract infection in patients with multiple sclerosis . Multiple Sclerosis and Related Disorders . 2020 ; 45 .
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