Prognosis

Developing an accurate prognosis for an individual MS patient is notoriously difficult owing to the multitude of variables involved. Many studies suggest that the rate of progression to disability may vary due to a number of factors, including: age of onset, clinical type of disease, nervous system pathways involved, attack frequency, patient ability to compensate and patient comorbidities. The majority of patients experience MS as an incrementally disabling disease that evolves over decades. Most can expect a nearly normal lifespan with a cause of death similar to the general population.

While some patients will maintain independance, those whose disability cannot be managed at home may need placement in an assisted living center or skilled nursing facility. The National Multiple Sclerosis Society states that "only about 5–10% of the MS population requires chronic nursing home care"*. In general, MS nursing home residents are younger, well educated and their intellect is largely intact. MS patients that require nursing home placement often have some form of cognitive impairment. The National Multiple Sclerosis Society suggests that "A neuropsychology consult can be invaluable in defining the cognitive issue(s) and working with staff and the resident to compensate for it. Impairment of judgment, planning and organizational function may have an impact on the safety of operating wheelchairs, especially power-operated wheelchairs or scooters. An occupational therapist should be consulted to address issues of safe driving for individuals with MS who are experiencing cognitive problems."

As patients with MS age, common age-associated changes may complicate the management of MS patients in facilities primarily designed for aging adults. Other chronic illnesses such as osteoporosis, stroke, and diabetes may compound the management of these patients. Shared apartments with attendant care, group residences, and adult day treatment centers are potential settings where independent living can be promoted and nursing home placement for persons with severe MS can be delayed.


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The prognosis for people with MS is highly variable.
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