Multiple sclerosis: analysis of primary disability in St. Petersburg in 2016–2018

Multiple sclerosis is the most common cause of disability in young patients with neurological problems, which makes it the most important medical, social, and economic problem. Analysis of the structure and dynamics of primary disability resulted from multiple sclerosis in the city of St. Petersburg was carried out from 2016 through 2018. The proportion of patients with multiple sclerosis, who were for the first time identified as disabled, was 1 in 166 (0.6%) examinations in 2016; 1 in 142 (0.7%) in 2017; and 1 in 135 (0.74%) in 2018. In the course of three years, 74.2% of patients were assigned to the third-degree disability group; 21.2% to the second-degree disability group; 3.2% to the first-degree disability group; and 1.4% of patients were deemed a “disabled child” status. Working age people (26–45 years old) prevailed among those first recognized as disabled, which accounted for 58.6%.

Analysis of types of multiple sclerosis course carried out for the year 2017 showed the prevalence of relapsing-remitting multiple sclerosis accounting for 86% of cases. Main indicators associated with the disability were as follows: work-related limitations (98.7%), limited ability to move independently (93.4%), and limited ability to perform activities of daily living (19.9%). This study showed an increase in the number of people first recognized as disabled among patients with multiple sclerosis during this period, which probably results from multiple sclerosis incidence and prevalence growth. Patients of working age with third-degree disability, predominantly women with relapsing-remitting multiple sclerosis, prevail among patients with multiple sclerosis who were first recognized as disabled, which corresponds to the literature data. Leading indicators of disability are: work-related limitations, limited ability to move independently, and limited ability to perform activities of daily living. Data obtained indicated a high medical, social, and economical significance of multiple sclerosis, which confirm the need for earliest diagnosis and timely initiation of therapy in order to slow down the disability progression in patients of working age.