Quantifying the Association between Objectively Measured Physical Activity and Multiple Sclerosis in the UK Biobank

Abstract

ABSTRACT Introduction Objectively measured physical activity (PA) data were collected in the accelerometry substudy of the UK Biobank. UK Biobank also contains information about multiple sclerosis (MS) diagnosis at the time of and after PA collection. This study aimed to 1) quantify the difference in PA between prevalent MS cases and matched healthy controls, and 2) evaluate the predictive performance of objective PA measures for incident MS cases. Methods The first analysis compared eight accelerometer-derived PA summaries between MS patients (N = 316) and matched controls (30 controls for each MS case). The second analysis focused on predicting time to MS diagnosis among participants who were not diagnosed with MS. A total of 19 predictors including eight measures of objective PA were compared using Cox proportional hazards models (number of events = 47; 585,900 person-years of follow-up). Results In the prevalent MS study, the difference between MS cases and matched controls was statistically significant for all PA summaries (P < 0.001). In the incident MS study, the most predictive variable of progression to MS in univariate Cox regression models was lower age (C = 0.604), and the most predictive PA variable was lower relative amplitude (RA, C = 0.594). A two-stage forward selection using Cox regression resulted in a model with concordance C = 0.693 and four predictors: age (P = 0.015), stroke (P = 0.009), Townsend deprivation index (P = 0.874), and RA (P = 0.004). A model including age, stroke, and RA had a concordance of C = 0.691. Conclusions Objective PA summaries were significantly different and consistent with lower activity among study participants who had MS at the time of the accelerometry study. Among individuals who did not have MS, younger age, stroke history, and lower RA were significantly associated with a higher risk of a future MS diagnosis.