الفهرس 
E PIDEMIOLOGY OF M ULTIPLE S CLEROSISOnly 14 pages are availabe for public view
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Abstract
Background: Multiple sclerosis is an immune-mediated neuro-inflammatory and neurodegenerative disease. It affects mostly young adults between 20 and 40 years of age and women about 2–3 times more often than men. Disease severity and prognosis are hard to predict, different disease courses are observed in patients. It is the second most common cause of disability in young adults, and it is one of the costliest chronic diseases.
Aim of the study: Our study aims to Asses risk factors affecting cognitive impairment (CI) in MS patients, focusing on risk factors including; Body Mass Index (BMI), Vitamin D level, Smoking and Alcohol and Physical activity.
Patients and methods: It is a cross-sectional study carried on 50 patients with definite MS from MS unit at Ain-Shams University with inclusion and exclusion criteria was conducted, where the subjects were assessed regarding their basic demographic data, Body Mass Index (BMI), Vitamin D level, Smoking and Alcohol and Physical activity and correlated these data with their cognitive function where patients were classified to cognitive impaired or cognitive preserved using SDMT scale
Results: Patients’ weight, height and BMI showed no significant correlation with the cognitive impairment assessed by SDMT. There was no significant correlation between cognitive impairment assessed by SDMT and smoking, Alcohol intake, BMI, vitamin D level, caffeine intake past or current physical activity. Our study showed a significant correlation between the cognitive impairment and the type of treatment of MS, where patients on 1st line DMD showed the majority of Cognitively preserved patients; 15 out of 18 patients with a percentage of 83.3 % while patients on 2nd line DMD showed the majority of Cognitively impaired patients, 17 patients with a percentage of 53.1 %. And thus could be related to disease progression not type of treatment itself as patients who are on 2nd line DMD are mostly the most progressive.
Conclusion: Cognitive affection of MS could be part of disease progression itself and not related to risk factors. This exploratory study underscores the complexity of physiopathological mechanisms underlying CI in MS and provides a few clues to further research in this area.