The Prevalance of Malnutrition and Its Association With Disability in Patients With Relapsing-Remitting Multiple Sclerosis

The Prevalence of Malnutrition and Its Association With Disability in Patients With Relapsing-Remitting Multiple Sclerosis: A Prospective Cross-Sectional Observational Study

This prospective observational study aims to determine the prevalence of malnutrition in patients with relapsing-remitting multiple sclerosis and to evaluate its association with disability. Nutritional status will be assessed using the Mini Nutritional Assessment-Short Form, and body composition will be evaluated with bioelectrical impedance analysis and anthropometric measurements. The study will also assess urinary incontinence, depression, and anger-related features, and compare the findings with those of healthy controls.

Multiple sclerosis is a chronic inflammatory and demyelinating disease of the central nervous system that may lead to disability, reduced mobility, bladder dysfunction, depression, and impaired quality of life. In the early stages of the disease, overweight and obesity may be common, whereas with disease progression, malnutrition and cachexia may become more prominent. Malnutrition may contribute to muscle loss, reduced mobility, worsening functional status, and increased clinical burden.

This single-center, hospital-based, prospective cross-sectional observational study will be conducted in the multiple sclerosis and neurology outpatient clinics of Antalya Training and Research Hospital. Adult patients diagnosed with relapsing-remitting multiple sclerosis and healthy controls will be included. Nutritional status will be assessed using the Mini Nutritional Assessment-Short Form. Body composition and anthropometric parameters, including waist-to-height ratio, waist-to-hip ratio, body fat percentage, fat mass, fat-free mass, total body water, and predicted muscle mass, will be evaluated using bioelectrical impedance analysis and standard anthropometric measurements. Disability in the patient group will be assessed with the Expanded Disability Status Scale. Depression, anger-related characteristics, and urinary incontinence profiles will also be evaluated using structured questionnaires and validated scales.

The study is designed to investigate the prevalence of malnutrition in relapsing-remitting multiple sclerosis, compare nutritional and related clinical parameters with healthy controls, and examine the relationship between malnutrition, body composition, and disability.

Inclusion Criteria:

• Age 18 years or older
• Diagnosis of relapsing-remitting multiple sclerosis for the patient group
• Absence of another medical condition that markedly impairs walking, such as severe cardiovascular disease, respiratory disease, or major orthopedic conditions
• Healthy volunteers willing to participate as controls
• Written informed consent provided

Exclusion Criteria:

• EDSS score ≥7 in the relapsing-remitting multiple sclerosis group
• Multiple sclerosis relapse during the last 30 days
• Systemic glucocorticoid treatment during the last 30 days
• History of musculoskeletal disease
• History of neuromuscular junction disease