A longitudinal study of variations in and predictors of fatigue in multiple sclerosis

Abstract

Objectives: To describe variations in fatigue over the course of 2 years in a sample of persons with multiple sclerosis (MS), and to investigate the predictive value of the following variables on variations in fatigue: sex, age, sense of coherence, living with a partner, living with children, work status, immunomodulatory treatment, mood, disease severity, disease course, time since diagnosis and time. Methods: Every 6 months, 219 outpatients at an MS specialist clinic were assessed using the Fatigue Severity Scale (FSS). Predictive values were explored with Generalised Estimating Equation employing proportional odds models; FSS scores were categorised as nonfatigue, borderline fatigue or fatigue. Results: FSS scores varied significantly (p = 0.02); 54% changed FSS category one or several times, 27% were persistently fatigued and 19% persistently non-fatigued. Independent predictors of increased fatigue were depressive symptoms, weak/moderate sense of coherence, living with a partner and not working. Furthermore, moderate disease severity predicted increase when combined with .10 years since diagnosis or a progressive course. Independent predictors of decreased fatigue were no depressive symptoms, strong sense of coherence, living alone and working. Moreover, mild and severe disease predicted a decrease when combined with .10 years since diagnosis, and mild severity combined with a progressive course. Conclusion: Mood, sense of coherence and living with a partner were independent predictors of fatigue in persons with MS. In addition to monitoring disease related variables, health related services should apply a broad range of approaches and repeatedly assess fatigue in persons with MS, to provide preventive care and appropriate interventions.

A population‐based study of associations between current posttraumatic stress symptoms and current fatigue

“…The translation and psychometric properties of the Norwegian version was satisfactory, with an alpha coefficient of .88 in this sample (Lerdal et al, 2005). Individuals with severe fatigue were defined by a FSS score ≥ 5.0, a cutoff value that has been used in several studies, and individuals with lower FSS score belonged to the nonsevere fatigue group (Johansson, Ytterberg, Hillert, Widen, & von Koch, 2008;Lerdal et al, 2007).…”

Changes in Fatigue and Cognition in Patients with Relapsing Forms of Multiple Sclerosis Treated with Natalizumab

“…In patients with MS, fatigue and cognition may worsen with time. 36,37 Given the long duration of this trial, if natalizumab had little or no effect, one might expect an average increase (worsening) in fatigue scores and evidence of increasing cognitive dysfunction. In contrast, ENER-G data demonstrate a sustained positive effect of natalizumab on measures of fatigue and cognition in MS patients.…”

A 7-item version of the fatigue severity scale has better psychometric properties among HIV-infected adults: an application of a Rasch model

“…The fatigue severity scale (FSS) [16] is one of the most frequently used fatigue measures for adults with chronic illness, including multiple sclerosis [17] and stroke [18]. It has also been used in studies of people with HIV [10,[19][20][21] and in the general population [22].…”