Evidence map›Paper›PMID 41235722›Full record

ArticleAnnals of clinical and translational neurology2026

Frailty Exacerbates Disability in Progressive Multiple Sclerosis.

Taylor R Wicks, Anna Wolska, Diala Ghazal, Dejan Jakimovski, Bianca Weinstock-Guttman, Alexander Burnham, Niels Bergsland, Michael G Dwyer, Alan T Remaley, Robert Zivadinov and 1 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Frailty Exacerbates Disability in Progressive Multiple Sclerosis.Annals of clinical and translational neurology · 2026
    Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Taylor R WicksDepartment of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.ORCID 0009-0004-5803-6222
Anna WolskaLipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
Diala GhazalDepartment of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.
Dejan JakimovskiJacobs Multiple Sclerosis Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.
Bianca Weinstock-GuttmanJacobs Multiple Sclerosis Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.
Alexander BurnhamThe Boston Home, Dorchester, Massachusetts, USA.
Niels BergslandBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.ORCID 0000-0002-7792-0433
Michael G DwyerJacobs Multiple Sclerosis Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.ORCID 0000-0003-4684-4658
Alan T RemaleyLipoprotein Metabolism Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
Robert ZivadinovJacobs Multiple Sclerosis Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.ORCID 0000-0002-7799-1485
Murali RamanathanDepartment of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, New York, USA.ORCID 0000-0002-9943-150X

Funding

Annette Funicello Research Fund for Neurological DiseasesDepartment of Defense Congressionally Directed Medical Research Programs MS190096Jacquemin Family Foundation
6 · The paper itself

Abstract

backgroundTo evaluate frailty in severe progressive multiple sclerosis (PMS) and to investigate the underlying mechanisms.

methodsThis prospective, cross-sectional, multicenter study enrolled a late severe PMS group requiring skilled nursing (n = 53) and an age, sex, and disease duration-matched control PMS group (n = 53). Participants received neurological and MRI assessments and provided blood samples. Frailty was measured on the Edmonton Frail Scale. Disability was measured on the Expanded Disability Status Scale (EDSS), and fatigue was assessed on the Fatigue Severity Scale. The inflammatory vulnerability index (IVX) and metabolic vulnerability index (MVX) were computed from nuclear magnetic resonance spectroscopy-derived metabolomic profiling. Serum neurofilament (sNfL), glial fibrillary acidic protein (GFAP), and growth differentiation factor 15 (GDF15) levels were obtained.

resultsThe late severe PMS group had a higher median EDSS (8.0 vs. 6.0, p < 0.001) than the matched control PMS group. The late severe PMS group had a higher prevalence of frailty (73.1% vs. 23.1%, p < 0.001) and higher frailty scores (8.87 vs. 5.52, p < 0.001) than the control PMS group. EFS was associated with EDSS in both PMS groups. Positive frailty status was associated with a 1.19-point greater EDSS (p = 0.012) in the control PMS group and a 0.436-point greater EDSS in the late severe PMS group (p = 0.002). In PMS controls, the EFS and frailty status were associated with IVX (p = 0.044 for EFS) and MVX (p = 0.036 for EFS).

conclusionsFrailty is positively associated with MS disability. Inflammatory and metabolic vulnerability are associated with frailty in PMS.

Indexed as

FrailtyMultiple Sclerosis, Chronic ProgressiveAgedCross-Sectional StudiesDisability EvaluationDisease ProgressionFatigueFemaleHumansMaleMiddle AgedProspective StudiesSeverity of Illness Indexagingfrailtymetabolic dysfunctionprimary progressive multiple sclerosissecondary progressive multiple sclerosis

Identifiers

PMID41235722
PMCPMC13071105

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.