Approved Research

Sarcopenia in Multiple Sclerosis

Lay summary

Multiple sclerosis (MS) is a disease of the central nervous system that can cause periods or new or worsening neurological deficits and progression of disability. The disease affects about 2.8 million individuals worldwide and is the most common non-trauma related cause of disability in young adults. With improvements in diagnosis and therapy, there is a rapid growth in the number of older adults living with MS. Older adults with MS commonly experience worsening weakness or decline in function, which is difficult for clinicians to distinguish between the patient's MS getting worse or age-related changes that are not due to MS. A common cause of age-related weakness is a condition called sarcopenia, which is the gradual loss of muscle mass and strength and results in decline in function. Sarcopenia is common with older age and is present in 10-40% of community-dwelling older adults depending on the definition of sarcopenia used. However, research suggests that sarcopenia is underrecognized and underdiagnosed, which adds significant health and economic burdens to patients and society. The goal of this study is to determine the prevalence of sarcopenia in people with MS using data from the UK Biobank. Previous studies have found that patients with neurological conditions are at higher risk of developing sarcopenia. However, prior studies have not adequately studied the prevalence of sarcopenia in MS. This study will use data from the UK biobank to estimate the prevalence of sarcopenia in people with MS compared to people without MS and determine whether sarcopenia in MS is associated with worse health outcomes such as falls, hospitalizations, mortality, and patient-reported quality of life. The results of this study will provide the basis for additional studies that will further characterize the relationship between sarcopenia and MS-related disease outcomes and ultimately lead to future interventional studies to treat sarcopenia in MS to improve physical function. The recognition of sarcopenia in MS will lead to better care of individuals with MS by improving the diagnosis, prevention, and treatment (such as a tailored exercise regimen) of this underrecognized yet prevalent age-related cause of weakness and loss of function in people with MS.

Current scope:

Research questions: What is the prevalence of sarcopenia in people with MS? Is having sarcopenia in MS associated with worse health outcomes such as increase hospitalizations, mortality, and worse patient reported quality of life?

Aim 1: To determine the prevalence of sarcopenia in MS compared with age- and sex-matched controls and associations of sarcopenia in MS with health outcomes such as hospitalizations, mortality, and patient-reported quality of life using archival data from the UK Biobank. Hypothesis: Sarcopenia is more prevalent in people with MS compared to those without MS, and people with MS with sarcopenia have worse health outcomes including higher risk of hospitalizations and mortality and lower reported quality of life adjusting for age and sex.

Research question: is having sarcopenia in MS associated with worse MS disease outcomes?

Aim 2: To prospectively determine associations between sarcopenia and its relation to MS disease outcomes in people with MS. Hypothesis:  Sarcopenia severity in MS is associated with higher neurological disability, increased MS lesion burden, lower brain volume, and worse cognition.

New scope:

Research question: Is having sarcopenia in MS associated with accelerated biological aging?

Aim 3: To determine the association between sarcopenia in MS and biological aging as measured by telomere length. Hypothesis: people with MS with sarcopenia have accelerated biological aging (shorter telomere length) adjusting for chronological age and sex.