Search Results (81)

This community-engaged qualitative study co-defined digital health and artificial intelligence (AI) priorities with First Nations communities in Manitoba, Canada, including those with disabilities. Grounded in Indigenous research methodologies and community-based participatory research, the project responded to persistent inequities in rehabilitation and health service access shaped by geography, colonial legacies, and jurisdictional fragmentation. These inequities are especially important in the context of aging, as older adults and Elders may experience compounded barriers related to disability, chronic conditions, mobility limitations, and digital exclusion. Over approximately 12 months, an interdisciplinary team consisting of First Nations scholars and partners, disability organizations, clinicians, and researchers conducted relationship-building visits and meetings with First Nations leadership, Elders/Knowledge Keepers, health providers, and community members to inform the design of a Gathering focused on disability, digital health, and AI. A one-day community-engaged Gathering was held on Treaty 1 and 2 Territory in Winnipeg and convened approximately 70 participants from multiple First Nations communities and disability/health organizations. Five facilitated roundtables explored: (1) health and research priorities for First Nations persons with disabilities; (2) primary care and disabilities; (3) digital access and cultural safety; (4) culturally safe and ethical AI use; and (5) health system challenges, disability, and digital health. Data consisted of facilitator-produced, de-identified table summaries, facilitator reflection forms, and participant-validated plenary notes; no recordings or individual sociodemographic data were collected. Using qualitative description and team-based content analysis, three interrelated domains emerged: (1) relationships, identity, trust, and cultural safety; (2) system, infrastructure, and equity conditions required for accessible care and digital inclusion (e.g., connectivity “dead zones,” device access, transport, and culturally safe services); and (3) opportunities, risks, and governance principles for AI and data use (e.g., AI literacy, privacy, bias, Indigenous data sovereignty, and Nation-specific governance). Findings emphasize that equitable digital health and AI must be relational, disability-informed, culturally safe, and led under First Nations authority, with AI positioned to support, rather than replace, human care relationships. The findings also highlight the importance of designing digital health and AI initiatives that remain accessible and trustworthy for older adults and Elders, particularly where aging, disability, and rural or remote living intersect. Full article

Background/Objectives: Population aging has increased the incidence of non-Hodgkin lymphoma in older adults, who often receive suboptimal treatment. Geriatric assessment is a key tool to evaluate frailty and guide therapeutic decisions. CAR T-cell therapy is effective but associated with significant toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which may be more severe in older patients. This study evaluated the role of geriatric assessments in patients aged 70 years and older referred for CAR T-cell therapy, focusing on patient profiles, treatment-related toxicities and clinical outcomes. Methods: This retrospective descriptive study included all patients aged 70 years and older for whom CAR T-cell therapy was considered at our institution between 15 December 2022 and 31 January 2026. Data were collected through medical record review. Descriptive and exploratory statistical analyses were performed. Results: A total of 43 patients aged 70 years or older with a diagnosis of refractory non-Hodgkin lymphoma underwent geriatric assessment prior to CAR T-cell therapy (median age: 73 years; 58% male). Most patients lived at home (98%), often with a cohabiting partner (65%). Polypharmacy (72%), mobility impairment (19%) and cognitive impairment (49%) were prevalent among our study population. Among the evaluated patients, CAR T-cell therapy was recommended in 35 cases, of whom 27 subsequently received treatment. In total, 85% developed CRS and 59% developed ICANS. ICANS occurred slightly more frequently in patients with pre-existing neurocognitive impairment (7 out of 11, 64%), compared with 9 out of 16 (56%) among those without cognitive impairment. The median length of hospitalization was 16 days. Mean overall survival post CAR T-cell therapy reached 324 days as of 31 January 2026 (median 277 days). Patients who were not recommended for CAR T-cell therapy exhibited a markedly higher burden of frailty compared with those who were and most of these vulnerabilities had not been identified before the geriatric evaluation. Conclusions: This study highlights the importance of oncogeriatric assessment in the context of CAR T-cell therapy to personalize treatment strategies according to patients’ frailty profiles. It may help optimize the care plan, potentially identifying patients most likely to benefit from therapy, while minimizing treatment-related toxicities. It also helps estimate the risk of treatment-related toxicities and facilitates the identification of previously unrecognized vulnerabilities. Full article

Background/Objectives: Fear of childbirth may begin before pregnancy and may be shaped by earlier traumatic and relational experiences. This study examined the association between intimate partner violence (IPV) and prior-to-pregnancy fear of childbirth among non-pregnant women and considered its implications for preconception and obstetric care. Methods: This descriptive, correlational, cross-sectional study was conducted online in Türkiye between 1 January and 31 May 2025 after approval from the Non-Interventional Scientific Research Ethics Committee of Istanbul Atlas University (23 December 2024; No. 10/07). The sample comprised 125 nulligravid women, defined as women who had never previously been pregnant, who were aged 18 years or older, were not currently pregnant, were living with an intimate partner, were literate in Turkish, and reported no psychiatric disorder. Data were collected using a Personal Information Form, the Husband Violence Against Women Scale (HVWAS), and the Fear of Childbirth Prior to Pregnancy Scale (FCPPS). Descriptive statistics, Spearman correlation analysis, Mann–Whitney U tests, and Kruskal–Wallis tests were performed. Results: The mean age of participants was 28.84 ± 5.47 years. The mean HVWAS score was 46.11 ± 12.51, and the mean FCPPS score was 36.05 ± 13.56. HVWAS scores were weakly positively correlated with prior-to-pregnancy fear of childbirth (rho = 0.207, p = 0.020). An exploratory association was observed between educational level and HVWAS scores (p = 0.019); however, the educational subgroups were highly unequal in size. No significant association was found between educational level and FCPPS scores (p = 0.219). Conclusions: Higher HVWAS scores were weakly associated with greater prior-to-pregnancy fear of childbirth. Because of the cross-sectional design, the direction and causality of this association cannot be determined. Confidential assessment of IPV and childbirth-related fear during preconception counseling and women’s health encounters may assist in identifying women who could benefit from further psychosocial evaluation and support. Full article

Background/Objectives: Norway’s ageing population includes many older adults living alone who receive home care and are at increased risk of loneliness. Loneliness is the subjective sense of unmet or imbalanced social needs, shaped by culture and living conditions, and can be social (lack of contact) or emotional (absence of close, trusting relationships). In older people, it often follows partner or role loss or reduced mobility or participation and is associated with emotional pain, lowered self-worth and poorer health and quality of life. This study aimed to explore patients’ experiences of loneliness while living alone and receiving home care. Methods: Twelve older patients (aged 74–98 years) participated in in-depth interviews, which were analysed using phenomenological-hermeneutical analysis in line with Lindseth and Norberg’s recommendations. Results: The results are presented under the following themes: (I) An overwhelming and painful feeling, (II) A presence without connection, and (III) Experiencing a sense of alienation. Conclusions: This study describes complex feelings of loneliness for the majority of participants, often worsened by poor mobility and shrinking social networks. From the patient perspective, good home care goes beyond practical and medical tasks: patients need to be treated as whole persons, with respect and understanding, to alleviate loneliness. Staffing stability, predictable visiting times, time for conversation, and small acts of kindness are central to well-being and the prevention of loneliness. Municipal healthcare should prioritize relationship-building, communication skills, and organizational solutions that enable continuity and flexibility. Focusing on the patient perspective in planning and evaluation will create better targeted interventions and support dignified ageing. Full article

Objective: The objective of this study is to examine the detailed pregnancy and neonatal outcomes of women without male partners undergoing intrauterine insemination (IUI) compared to women with male partners. Methods: This is a retrospective cohort study of all patients who completed an IUI cycle from 2017 to 2023. 2414 cycles were included in the study: 149 cycles for women without male partners (including single and lesbian women) and 2265 cycles for women with male partners. Primary outcomes were the rates of clinical pregnancy, miscarriage, and live birth. Secondary outcomes were obstetric complication rates and neonatal outcomes. Results: Women without male partners undergoing IUI were significantly older than the reference cohort (median age 42 years versus 38 years, p < 0.0001). 84.1% of women without male partners did not have a diagnosis of the common causes of female infertility. Both cohorts had similar cycle characteristics and number of IUI cycles until pregnancy and live birth. The mean clinical pregnancy rate per cycle for women without male partners was 11.4% versus 12.5% for the reference group (p = 0.56), and the mean live birth rate was 8.1% versus 8.2% (p = 0.95). Multiple pregnancy, cumulative pregnancy, and clinical miscarriage rates were also similar. Similarities persisted after adjusting for confounders: age, BMI, race, and infertility diagnosis. Importantly, there were no statistically significant differences in obstetric complications (such as hypertensive disorders of pregnancy, gestational diabetes, placental disorders) and neonatal outcomes. Conclusions: Compared to women with male partners undergoing IUI, women without male partners had similar rates of clinical pregnancy (per cycle and cumulative), miscarriage, and live birth; there were no significant differences in obstetric complications or neonatal outcomes. Full article

The aging population is a global phenomenon that represents a significant demographic shift, with life expectancy closely related to individuals’ functional capacity. Background/Objectives: Identify latent dimensions in self-perceived functional variables among Brazilian older adults. Methods: This cross-sectional study used data from module K of the 2019 National Health Survey (NHS) in Brazil. Multivariate statistics were applied using Principal Component Analysis (PCA). Results: The sample consisted of 22,728 older adults from all regions of Brazil, with a predominance of females (56%), an average age of 70 years (CI: 69.68–70.03), 61% engaged in weekly physical exercise, and most living with a spouse or partner (56.3%). The multivariate statistical analysis, conducted through PCA, resulted in two distinct macro-dimensions of functionality: Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). When analyzing each macro-dimension separately, we identified internal micro-dimensions. Within ADLs, two subdimensions stood out: ADLs Upper Limb Function and ADLs Lower Limb Function. Within IADLs, the micro-dimensions included IADLs Health Management and IADLs Independent Outdoor Mobility. Close results in the subdimensions of variable K25 did not allow for a clear distinction between the estimated IADLs. However, given the importance of this variable in explaining the cognitive aspect of the functional capacity construct, we suggest maintaining it as a separate subdimension: IADLs Financial Management. Conclusions: The latent dimensions of functional capacity identified in this study may help guide functional assessment in older adults, inform therapeutic decision-making, shape public policy, and support further research on functional capacity in aging populations. Full article

Unintended pregnancies among adolescent and young women in low- and middle-income countries pose major public health challenges, underscoring the need for improved access to modern contraceptives. This study examined prevalence, preferences, and correlates of modern contraceptive use among young women living in urban slums of Kampala, Uganda, to inform targeted interventions. We analyzed baseline data from The Onward Project On Wellbeing and Adversity (TOPOWA), an NIH-funded, multi-component prospective cohort study on mental health among women aged 18–24 years. In 2023, 300 participants were recruited from three sites (Banda, Bwaise, Makindye). Interviewer-administered surveys assessed contraceptive choices, lifestyle, and demographic factors. Modified Poisson regression was used to examine correlates of contraceptive use. Among participants, 66.0% had ever used contraception, 40.0% were current users, and 38.0% reported modern contraceptive use. Multivariable analyses showed that having a consistent partner (PR = 3.28; 95% CI: 1.90–5.67), engaging in sex work (PR = 2.10; 95% CI: 1.46–3.02), older age (PR = 1.08; 95% CI: 1.01–1.16), and having children (PR = 1.72; 95% CI: 1.12–2.66) were associated with higher modern contraceptive use. Findings highlight important gaps in sustained contraceptive use and the need for tailored interventions addressing economic, social, and educational barriers to improve reproductive health in this low-resource setting. Full article

Background: Transitions from hospital to long-term care (LTC) facilities are critical periods for older adults living with dementia, often involving complex medical, cognitive, and psychosocial needs. Virtual team-based care has emerged as a promising strategy to improve communication, coordination, and continuity of care during these transitions. However, there is limited evidence on how such approaches are implemented in practice, particularly with respect to inclusion, equity, and engagement of older adults and families. Objective: This study aimed to identify the enablers and barriers to delivering virtual team-based care to support older adults with dementia in transitioning from hospital to LTC. Methods: We conducted a qualitative study using semi-structured interviews, focus groups, and a policy review. Data were collected from 60 participants, including healthcare providers, older adults, and family care partners across hospital and LTC settings in British Columbia, Canada. Thematic analysis was conducted using a hybrid inductive and deductive approach. Eighteen institutional policies and guidelines on virtual care and dementia transitions were reviewed to contextualize findings. Results: Four themes were identified: (1) enhancing communication and collaboration, (2) engaging families in care planning, (3) digital access and literacy, and (4) organizational readiness and infrastructure. While virtual huddles and secure messaging platforms supported timely coordination, implementation was inconsistent due to infrastructure limitations, unclear protocols, and staffing pressures. Institutional policies emphasized privacy and security but lacked guidance for inclusive engagement of older adults and families. Many participants described limited access to reliable technology, a lack of training, and the absence of tools tailored for individuals with cognitive impairment. Conclusions: Virtual care has the potential to support more coordinated and inclusive transitions for people with dementia, but its success depends on more than technology. Structured protocols, inclusive policies, and leadership commitment are essential to ensure equitable access and meaningful engagement. The proposed VIRTUAL framework offers practical tips for strengthening virtual team-based care by embedding ethical, relational, and infrastructural readiness across settings. Full article

Adult women’s nutritional status reflects a complex interplay of biological, social, and environmental determinants. This study aimed to analyze the association between adverse childhood experiences (ACEs), intimate partner violence (IPV), and inadequate nutritional status among women in Vitória, Espírito Santo, Brazil. We conducted a cross-sectional, population-based survey with 1.073 women aged 18 years or older. The body mass index (BMI) is categorized into adequate weight and inadequate weight, with the latter comprising excess weight (overweight and obesity) and extremes of weight (underweight or obesity). Experience of violence was measured with ACEs and IPV. Logistic regression analyses were performed to identify associations, adjusting for sociodemographic variables. Women who reported ACEs, such as parental divorce/separation and living with family members who used alcohol, illicit drugs, or prescription drugs, were 1.4 times more likely to be excess weight compared with those who did not experience ACEs (OR = 1.37; 95%CI:1.02–1.83; p = 0.035 and OR = 1.35; 95%CI:1.01–1.80; p = 0.041, respectively). Among those with extreme BMI values, the association with parental divorce/separation also remained significant after adjustment (OR = 1.59; 95%CI: 1.13–2.25; p = 0.009). These findings suggest that ACEs have lasting effects throughout life, influencing body weight in adult women and contributing to inadequate dietary status at both the lower and upper limits. Full article

Early palliative care improves quality of life for patients with life-limiting illnesses, but access is often inequitable. The goal of this study was to assess disparities in early specialist palliative care (SPC) consultation among newly diagnosed stage IV lung cancer patients. All newly diagnosed stage IV lung cancer patients in southern Alberta, Canada (June 2021–March 2022) were offered SPC consultations from a multidisciplinary team, post-oncology visit. A retrospective chart review analyzed demographic factors and consultation outcomes (accepted, ineligible, declined/unreachable), using the Pampalon Deprivation Index and NamSor surname analysis as proxies for equity-related variables. Of 113 patients, 76.2% were eligible for consultation, and 67.4% of those accepted consultation. Older age (>65 years), male sex, and high deprivation were linked to declining SPC (p < 0.05–0.01). Conversely, living alone or with a non-partner increased acceptance (p < 0.05). Age, sex, deprivation, and living situation influenced SPC acceptance. Identifying disparities can guide interventions to improve equitable access. Full article

Background/Objectives: In the aftermath of the COVID-19 pandemic, individuals infected with SARS-CoV-2 have progressively displayed a range of symptoms linked to protracted COVID during the post-acute phase of illness. Concurrently, in several nations globally, the phenomenon of population aging has been intensifying. In this scenario, the aged population has become both vulnerable and high-risk during the acute phase of COVID-19, and faces significant dangers associated with long-COVID. This study seeks to analyze the incidence and spatial distribution of health complications in older people affected by COVID-19, in the first year of the pandemic (2020), in the State of Paraná, as well as to identify the factors associated with the development of cardiovascular, neurological, respiratory, and metabolic diseases. Method: An observational and retrospective study was carried out in the Brazilian state of Paraná. Participants were randomly selected from two databases. A total of 893 older people (≥60 years) participated in the study 12 months after acute COVID-19 infection. Telephone questionnaires were applied between March and December 2021. The Moran index test, logistic regression, and Poisson models were used to analyze the data. Results: In terms of age, most participants (66%) were between 60 and 69 years old, 25.8% were between 70 and 79 years old, and 8.2% were 80 years old or older. Most participants were female (51.2%), white (98.1%), had a partner (69.8%), and had been hospitalized due to COVID-19 (59.3%). Cardiovascular diseases were the most frequent in the population (39.5%), followed by metabolic diseases (27.3%). The long-term use of medication was associated with the development of metabolic diseases (aOR = 9.8), cardiovascular diseases (aOR = 6.6), and diseases in multiple organic systems (aOR = 3.2); living alone was associated with neurological diseases (aOR = 2.5), and the age group of 80 years or older (aOR = 2.4) was associated with cardiovascular events. The spatial distribution showed that complications in body groups are distributed randomly among the health regions of the state, with no influence from neighboring locations. Conclusions: Post-COVID-19 health complications are more frequent in older adults who have comorbidities and long-term medication use. Therefore, long-term monitoring of these individuals and investment in public policies for rehabilitation and prevention of complications are necessary. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

Although the relationship between grandparent and grandchild is often unique due to the supportive and foundational roles grandparents can have in the lives of young or youthful grandchildren, the extent of grandparent–grandchild coresidence globally is under-researched. We harmonized household roster survey data on grandchild coresidence using population-based data on adults 55+ years across 24 countries. Grandchild coresidence rates ranged from 41.1% in Mexico to 0.1% in Sweden. Across contexts, grandchild coresidence was more common among women (compared to men), non-partnered individuals (compared to partnered individuals), those who reported difficulty with activities of daily living (compared to those without such difficulties), and those with education levels below the median (compared to those above the median). Logit regressions indicated gaps in rates of grandchild coresidence by partner status, ADL status, and education were generally not driven by income or other socio-demographic variables. Coresidence with adult grandchildren was not uncommon in most countries with non-negligible rates of grandchild coresidence. In about 25% of households of middle-aged and older adults coresiding with grandchildren, grandchildren ages 0–5 years were present. Future research should consider the meaning of grandparent–grandchild coresidence for the health outcomes of middle-aged and older adults globally, particularly when grandparents are not caregivers of grandchildren. Full article

Introduction: Hypoglossal nerve stimulation (HNS) “Inspire_© therapy” has garnered popularity among obstructive sleep apnea (OSA) patients seeking an alternative to continuous positive airway pressure (CPAP) therapy. The growth in HNS has been particularly high in older adults living with OSA. Consistent and proper use of HNS in the geriatric population faces unique age-associated barriers: a high rate of multiple chronic conditions (MCC) and polypharmacy (being on five or more drugs). Early recognition and patient-centered management of these barriers will allow older patients to obtain maximum benefits from HNS. HNS has distinct advantages in the geriatric population because it overcomes many concerns related to CPAP therapy adherence, such as mechanical limitations due to manual dexterity, maxillofacial anatomy, dental issues such as usage of dentures, allergy/otolaryngology-related disorders, and pre-existing post-traumatic stress disorder-related claustrophobia. This paper describes how we worked with older patients with OSA and their care partners to overcome these barriers so patients can continue to derive cardiovascular, neurologic, and quality of life benefits resulting from optimal OSA management. These benefits are especially important in the older population because of higher rates of comorbidities (dementia, coronary artery disease, and atrial fibrillation) exacerbated by sub-optimally treated OSA. In this article, we describe our clinical experience with elderly patients on Inspire_© therapy, with a focus on the everyday difficulties faced by these patients and the measures implemented to address and mitigate these barriers. Methods: A retrospective chart review was conducted to identify patients aged 65 and above who underwent hypoglossal nerve stimulator insertion. Experiences of older patients during and after the insertion procedure were documented and compared to a younger population of patients on HNS therapy. We specifically collected information on difficulties encountered during activation or follow-up visits and compared them between the different age groups. Using this information, we identified areas to improve treatment adherence from the patients’ perspectives. Results: We identified 43 geriatric (65 to 86 years old) patients who received the Inspire implant at a tertiary academic medical center and compared them to a younger population of 23 patients. Most common challenges noted—with a potential to impact adherence—included orofacial and lingual neuropraxia (ischemic or demyelination-induced neuropathy) at activation, cognitive dysfunction (memory problems), preexisting anxiety, and insomnia. Other difficulties that are less commonly reported but equally important to consistent and proper use of HNS included headaches, concerns of device malfunction, change in comfort levels after cardiac procedures, and general intolerance of the device. The older patient population had a statistically significant higher incidence of cognitive difficulties (30.2% vs. 4.4%) and a smaller social support system (62.8% vs. 91.3%) affecting device usage compared to the younger population. There were no statistically significant differences in the rates of other more commonly reported adverse effects such as headaches, dry mouth, and anxiety between the two age groups. Conclusion: Despite several challenges faced by geriatric patients, Inspire_© hypoglossal nerve stimulation remains a viable, alternative treatment option for OSA with improved tolerance and adherence compared to CPAP. After identifying less commonly reported barriers such as cognitive decline, sensory deficits, and decreased social support systems, minor adjustments and appropriate education on use allows older patients to correctly use and benefit from Inspire_© device therapy, with subsequent improvement in sleep and overall quality of life. Full article

Background/Objectives: Infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) poses a significant health risk, especially for individuals with chronic medical conditions. Multiple sclerosis (MS) is the most prevalent chronic, immune-mediated neurological disorder, and vaccinations are essential to its management. This study aimed to compare the reported willingness to be vaccinated against SARS-CoV-2 with the actual vaccination status among people with MS (pwMS) and identify factors explaining the discrepancy. Methods: In a longitudinal, two-center study, we analyzed 149 patients aged 18 or older with a diagnosis of clinically isolated syndrome or MS. The participants completed three surveys: a baseline survey (from June 2019 to June 2020), a pre-vaccine follow-up (from May to July 2020), and a post-vaccine follow-up (from October 2021 to January 2022). The data included sociodemographic, clinical, and psychological information. Results: Among the 149 participants, 122 (81.9%) received a SARS-CoV-2 vaccination, while 27 (18.1%) did not. The pwMS who were unwilling to become vaccinated and remained unvaccinated were less likely to live with a partner, had higher smoking rates, took more medications, had a higher number of previously discontinued disease-modifying therapies, and found pandemic policies inappropriate. No significant associations were found between vaccination willingness/status and factors like age, sex, depression, or anxiety. Conclusions: This study highlights the gap between vaccination willingness and actual status in pwMS, revealing factors associated with vaccine hesitancy. The findings of this study offer insights into addressing vaccine uptake. Full article