Background: Vascular comorbidity adversely influences health outcomes in several chronic condi-

Comorbidity is common in MS and similarly associated with socioeconomic status.

A simple walking test was developed with 159 (females = 80, males = 79) healthy 20-65-year-old subjects. All the subjects first walked the distances of 1.0, 1.5 and 2.0 km on a flat dirt road. Half of the participants were tested in the laboratory for maximal oxygen uptake (VO2max), and the 2-km test was repeated again twice. In a comparison of the three distances, the 2-km test was repeatable, the most preferable subjectively and the most accurate in predicting VO2max. A sex-specific prediction model including walking time, heart rate at the end of the walk, age and body mass index predicted 73-75% of the variance in VO2max (ml.kg-1.min-1) and that with body weight 66-76%, with a standard error of estimate of the order of 9-15% of the mean. The cross-validation of the models yielded reasonable accuracy in obese men and women and in moderately active men, and less accuracy in moderately active women and highly active men. These results suggest that a fast 2-km walk supplemented with simple measurements is a feasible and accurate alternative for determining the cardiorespiratory fitness of healthy adults.

Both diagnostic delay and disability at diagnosis are influenced by comorbidity. The mechanisms underlying these associations deserve further investigation.

Mental comorbidity remains underdiagnosed and undertreated in MS. Patients of lower socioeconomic status bear a disproportionate share of the burden of depression.

BackgroundEffective health communication is important for informed decision-making, yet little is known about the range of information sources used by persons with multiple sclerosis (MS), the perceived trust in those information sources, or how this might vary according to patient characteristics.ObjectiveWe aimed to investigate the sources of health information used by persons with MS, their preferences for the source of health information, and levels of trust in those information sources. We also aimed to evaluate how these findings varied according to participant characteristics.MethodsIn 2011, participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry were asked about their sources of health information using selected questions adapted from the 2007 Health Information National Trends (HINTS) survey.ResultsOf 12,974 eligible participants, 66.18% (8586/12,974) completed the questionnaire. Mass media sources, rather than interpersonal information sources, were the first sources used by 83.22% (5953/7153) of participants for general health topics and by 68.31% (5026/7357) of participants for MS concerns. Specifically, the Internet was the first source of health information for general health issues (5332/7267, 73.40%) and MS (4369/7376, 59.23%). In a logistic regression model, younger age, less disability, and higher annual income were independently associated with increased odds of use of mass media rather than interpersonal sources of information first. The most trusted information source was a physician, with 97.94% (8318/8493) reporting that they trusted a physician some or a lot. Information sought included treatment for MS (4470/5663, 78.93%), general information about MS (3378/5405, 62.50%), paying for medical care (1096/4282, 25.59%), where to get medical care (787/4282, 18.38%), and supports for coping with MS (2775/5031, 55.16%). Nearly 40% (2998/7521) of participants had concerns about the quality of the information they gathered.ConclusionsAlthough physicians remain the most trusted source of health information for people with MS, the Internet is the first source of health information for most of them. This has important implications for the dissemination of health information.

African Americans experience greater multiple sclerosis-associated disability than Caucasians. Failure to account for socioeconomic status leads to overestimation of these differences. Disease progression is similar in African Americans and Caucasians after diagnosis.

Our large cross-sectional survey suggests a healthy diet and a composite healthy lifestyle are associated with lesser disability and symptom burden in MS.