A variety of lifestyle factors are correlated with disability progression in patients with multiple sclerosis (MS), according to a study published in Multiple Sclerosis and Related Disorders.

The researchers found that lifestyle factors including physical activity, arterial hypertension, being overweight/obese, the use of lipid-lowering drugs, and cognitive reserve were all related to the accumulation of disability in patients with MS.

“Our results suggest an association between a ‘brain healthy lifestyle’ and disability in MS. These results also support the suggestion to adopt a ‘brain healthy lifestyle’ to prevent disability in MS,” the authors said.

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The use of multiple regression analysis (MRA) resulted in a model where cognitive reserve, physical activity level, type of MS (relapsing-remitting MS vs secondary progressive MS), systolic blood pressure, body mass index (BMI), and the use of lipid-lowering drugs could account for 22.2% of the variability in Multiple Sclerosis Severity Score (MSSS).

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An MRA model was also developed which found BMI, smoking status, and the use of lipid-lowering drugs accounted for 23% of the variance in serum neurofilament light chain (sNfL) z-score in a subset of patients with nonactive MS currently on high-efficacy treatment. SNfL was used as a proxy to monitor ongoing brain damage.

“A cognitive and physically active lifestyle, normal body weight, and well-controlled blood pressure may be crucial in building and retaining brain reserve. Randomized clinical trials investigating the effects of a brain-healthy lifestyle in general, rather than focusing on one risk factor, are warranted,” the authors concluded.

A total of 351 patients with MS were recruited for the trial with the majority being female (69.8%). The mean age of the patients was 43.04 years and most (86%) were diagnosed with relapsing-remitting MS. The mean score for MSSS was 4.03 while the Expanded Disability Status Scale score median was 2.5 with an interquartile range of 2.

A smaller subset of 99 patients were included in the sNfL data analysis with mean levels of 7.9 pg/ml and a mean z-score of 0.72. In general, the sNfL z-scores were higher in the patients with MS compared to healthy control values obtained from previous studies.


Van Hijfte L, Loret G, Bachmann H, et al. Lifestyle factors in multiple sclerosis disability progression and silent brain damage: a cross-sectional study. Mult Scler Relat Disord. 2022;65(104016):104016. doi:10.1016/j.msard.2022.104016