A number of potential biomarkers for monitoring of MS disease course, response to therapies and prediction of disability have been studied, some of them with promising results [7], [8].
The impact of comorbidity on the prediction of disability outcomes has not been well explored.
The long-term prediction of disability assessed with patients from the Framingham disability study, identified heart insufficiency to be predictive of disability in women [ 17].
Guralnik et al., using a small battery of functional tests, have shown that lower extremity function is an important parameter for the prediction of disability in later years [ 154].
This list was constructed based on previous research on methodological quality, quality of reporting criteria for observational research, and previous reviews regarding prediction of disability [ 14- 17].
Additionally, whilst the stability and prediction of disability remains poor during early childhood, developmental malleability of perinatal and environmental risk factors through EI is potentially high.
Wicksell and others [ 8] also found that the Avoidance subscale contributed more than the subscale Fusion to the prediction of disability in chronic pain.
Sourial et al. have recently shown that indicators of mobility, nutrition, physical activity and strength, in combination with cognition, improved the prediction of disability in older adults, beyond the contributions of age, sex and comorbidity.
A study based on data from cohorts of community-dwelling persons aged 65 years or older showed that adding frailty markers to age, sex, and chronic diseases provided an increase in the patient-level prediction of disability [ 57].
These findings indicate that physical frailty assessments including simple performance measurement (slowness, weakness) and questionnaires (exhaustion, low activity and weight loss) could be combined for a more effective prediction of disability incidence in the Japanese older population.
