{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:21:42Z","timestamp":1788531702026,"version":"build-2803163510"},"reference-count":34,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Many factors are associated with aging on multiple sclerosis progression. We assess associations of neighborhood resources and race with outcomes in aging people with multiple sclerosis (PwMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>We evaluated if worsening outcomes differed by neighborhood resources and race for PwMS age &gt;55.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A longitudinal cohort study of 1456 PwMS (mean age 61.7 (standard deviation (SD): 5.5), 73% female, 87% White race) was conducted at tertiary MS centers between 2015 and 2021 with 3\u20135\u2009years of follow-up. Predictors included area deprivation index (ADI) and race. Outcomes included 10 Neuro-QoL domains and three performance measures: manual dexterity test (MDT dominant hand), walking speed test (WST), and processing speed test (PST), with worsening defined using clinically meaningful changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In adjusted models, greater ADI (i.e. fewer resources) was associated with worsening MDT and WST (odds ratio (95% confidence interval (CI))\u2009=\u20091.12 (1.05\u20131.19), 1.09 (1.02\u20131.16), respectively), and with worsening on Neuro-QoL domains of social roles, stigma, and fatigue. Patients of Black race had less worsening on social roles and depression, compared to patients of White race.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study demonstrated an association between fewer neighborhood resources and worsening performance measures and self-reported outcomes. This study demonstrates that neighborhood deprivation, but less likely race, may play a role in worsening for PwMS &gt;55\u2009years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261423408","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:51:05Z","timestamp":1774313465000},"page":"1098-1108","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationships between neighborhood deprivation, race, and worsening outcomes among MS patients 55 years of age and older"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8026-1854","authenticated-orcid":false,"given":"Deborah M","family":"Miller","sequence":"first","affiliation":[{"name":"Mellen Center, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4930-2168","authenticated-orcid":false,"given":"Yadi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Husak","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Abbatemarco","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-9148","authenticated-orcid":false,"given":"Daniel","family":"Ontaneda","sequence":"additional","affiliation":[{"name":"Mellen Center, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2334-6883","authenticated-orcid":false,"given":"Robert A","family":"Bermel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"OMahony","sequence":"additional","affiliation":[{"name":"Mellen Center, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Lapin","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Neurological Institute, Department of Qualitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007035"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13692"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.693017"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12384-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1197212"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-025-13116-x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.7224\/1537-2073.2012-046"},{"key":"e_1_3_2_9_2","doi-asserted-by":"crossref","unstructured":"Siavoshi F Noroozi R Chang G et al. 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Research and Clinical Practice H-65.953 https:\/\/policysearch.ama-assn.org\/policyfinder\/detail\/H-65.953?uri=%2FAMADoc%2FHOD.xml-H-65.953.xml"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm11101006"},{"key":"e_1_3_2_16_2","first-page":"37","article-title":"Men with multiple sclerosis","volume":"2","author":"Safi N","year":"2021","unstructured":"Safi N, Krieger S. Men with multiple sclerosis. Pract Neurol 2021; 2: 37\u201340.","journal-title":"Pract Neurol"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-022-00735-5"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517690824"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1802313"},{"key":"e_1_3_2_20_2","first-page":"12","article-title":"The ADI-3: A revised neighborhood risk index of the social determinants of health over time and place","volume":"2021","author":"Berg K","unstructured":"Berg K, Dalton J, Gunzler D, et al. 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