Clinically Significant Fatigue: Prevalence and Associated Factors in an International Sample of Adults with Multiple Sclerosis Recruited via the Internet

Weiland, Tracey J; Jelinek, George A; Marck, Claudia H; Hadgkiss, Emily; Meer, Dania M van der; Pereira, Naresh G; Taylor, Keryn L

doi:10.1371/journal.pone.0115541

Cited by 117 publications

(120 citation statements)

References 64 publications

(69 reference statements)

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“…The study also showed a small inverse correlation between healthy diet and a 12-month relapse rate r = −0.117 with a 1.2% reduction in the 12-month relapse rate for each point increase in DHQ. This survey also separately evaluated fatigue in MS and its potential relationship with various dietary and physical health factors [10]. About two thirds of the survey participants reported clinically significant fatigue as assessed by the Fatigue Severity Scale (FSS).…”

Section: Introductionmentioning

confidence: 99%

Dietary Interventions and Multiple Sclerosis

Altowaijri

Fryman²,

Yadav

2017

Curr Neurol Neurosci Rep

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Multiple Sclerosis (MS) is a chronic, disabling neurologic disease that has its onset in young adulthood. While the knowledge about underlying pathogenesis of MS has improved significantly over the last few decades, the exact cause still eludes us. Despite the availability of several United States Food and Drug Administration-approved disease-modifying therapies (DMT) for MS in the last two decades, the disease remains disabling for many. DMT use is limited by its partial effectiveness, significant side effects in many cases, and high cost that leads people with MS (PwMS) to look for alternative management options. Dietary intervention as a possible mode to help MS seems very appealing to PwMS; however, scientific data supporting this notion remains sparse. New information on the role of various non-MS health factors, especially vascular disease risk factors such as hypertension, hyperlipidemia, salt intake, and obesity, that may play a role in MS pathogenesis appears very intriguing as it may partly explain the heterogeneity seen in MS activity and disability. This review will highlight the emerging information on various dietary approaches that may affect MS and their possible underlying mechanism.

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Section: Introductionmentioning

confidence: 99%

Dietary Interventions and Multiple Sclerosis

Altowaijri

Fryman²,

Yadav

2017

Curr Neurol Neurosci Rep

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“…We have previously demonstrated modifiable lifestyle factors are important predictors in their own right of fatigue [32] and depression risk [33], and may therefore indirectly affect sexual function and satisfaction with sexual function. Here, we were able to demonstrate that diet and level of physical activity are associated with these outcomes even after adjusting for other relevant factors.…”

Section: Discussionmentioning

confidence: 99%

“…There is potential for a lifestyle risk factor modification approach to the management of SD in PwMS, given the strong associations of better lifestyle behaviours with reduced depression risk [33] and fatigue [32], both known to adversely affect sexual function [22]. In type 2 diabetes, another chronic disease with strong lifestyle associations, intensive lifestyle intervention in obese women resulted in a significantly greater proportion remaining sexually active, improvements in sexual function, and greater likelihood of remission of SD at 1 year [43].…”

Section: Discussionmentioning

confidence: 99%

Sexual function in multiple sclerosis and associations with demographic, disease and lifestyle characteristics: an international cross-sectional study

et al. 2016

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BackgroundSexual dysfunction (SD) is very common in people with multiple sclerosis (PwMS) and contributes a significant burden of disease, particularly for young people. SD has direct neurological contributions from depression and fatigue, which occur commonly in PwMS. Modifiable factors may represent potential targets for treatment and prevention of SD. We aimed to assess the prevalence of SD and explore associations between SD and demographic and modifiable risk factors, as well as depression and fatigue in a large cohort of PwMS.MethodsWe analysed self-reported data from a large, international sample of PwMS recruited via Web 2.0 platforms, including demographic, lifestyle and disease characteristics. Specific sexual function questions included 4 items from the sexual function scale and 1 item regarding satisfaction with sexual function, part of the MS Quality of Life-54 instrument.Results2062 PwMS from 54 countries completed questions on sexual function. 81.1 % were women, mean age was 45 years, most (62.8 %) reported having relapsing-remitting MS. The majority (54.5 %) reported one or more problems with sexual function and were classified as having SD. Lack of sexual interest (41.8 % of women), and difficulty with erection (40.7 % of men) were most common. The median total sexual function score was 75.0 out of 100, and 43.7 % were satisfied with their sexual function. Regression modeling revealed independent associations between sexual function and satisfaction and a range of demographic factors, including age, as well as depression risk, antidepressant use, and fatigue in PwMS.ConclusionThis cross-sectional study shows that SD and lack of satisfaction with sexual function are associated with depression risk and fatigue, as well as modifiable lifestyle factors diet and physical activity (after adjusting for depression and fatigue). Planned longitudinal follow-up of this sample may help clarify these associations and the underlying mechanisms. There is potential to prevent and treat SD in PwMS by addressing depression and fatigue and their determinants. Clinicians and PwMS should be aware of SD and associated factors as part of a comprehensive preventive approach to managing MS.

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“…Adopting healthy behaviours may be indirectly associated with QOL, as an externally oriented locus of control, with a feeling of being unable to influence health outcomes, predicts worse disability but also depression and fatigue [42], both determinants of QOL in their own right, and both strongly associated with the lifestyle factors examined here [43, 44]. Having healthy behaviours may be associated with positive orientation of locus of control, with attendant benefits in motivation to access health information and better adherence to treatment [42].…”

Section: Discussionmentioning

confidence: 99%

Lifestyle, medication and socio-demographic determinants of mental and physical health-related quality of life in people with multiple sclerosis

et al. 2016

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BackgroundHealth-related quality of life (QOL) is a key outcome for people with multiple sclerosis (MS). While modifiable lifestyle factors, like smoking, physical activity and vitamin D, have strong associations with development and progression of MS, few studies have examined such associations with QOL.MethodsUsing patient-reported data from 2312 people with MS from 54 countries, regression models explored associations of socio-demographic, therapeutic and lifestyle factors with QOL, using the Multiple Sclerosis Quality of Life-54 (MSQOL-54).ResultsParticipants were on average 45.6 years old, 82.4% women, mostly partnered (74.1%), with a university degree (59.5%). Controlling for socio-demographic factors and disability, factors associated with better physical health composite (PHC) (on a 100 point scale) were: moderate and high physical activity compared to low (5.9 [95% confidence interval: 4.2, 7.6] and 9.9 [CI: 8.1, 11.6] points higher score respectively); non-smoking compared to current smoking (4.6 points [CI: 2.4, 6.7]); better diet (per 10 points on the 100 point Diet Habits Questionnaire scale (DHQ) 1.6 points [CI: 1.0, 2.2] points); normal body mass index (BMI) versus overweight or obese (2.1 points [CI: 0.4, 3.7] and 2.4 points [CI: 0.5, 4.3]); fewer comorbidities (4.4 points [CI: 3.9, 4.9]); and not taking a disease-modifying drug (DMD) (2.1 points [CI: 0.7, 3.4]).Better mental health composite (MHC) determinants were: moderate and high physical activity compared to low (4.0 points [CI: 2.0, 6.0] and 5.7 points [CI: 3.5, 8.0]); non-smoking compared to current (6.7 points [CI: 4.1, 9.3]); better diet (2.8 points [CI: 1.9, 3.5]); normal BMI versus overweight or obese (3.1 points [CI: 1.1, 5.1] and 3.5 points [CI: 1.3, 5.7]); meditating regularly (2.2 points [CI: 0.2, 4.2]); and no DMD use (2.9 points [CI: 1.3, 4.6]).ConclusionsWhile causality cannot be concluded from cross-sectional data, the associations between modifiable lifestyle factors and QOL suggest significant potential for secondary prevention of the known deterioration of QOL for people with MS through lifestyle risk factor modification.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0763-4) contains supplementary material, which is available to authorized users.

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Clinically Significant Fatigue: Prevalence and Associated Factors in an International Sample of Adults with Multiple Sclerosis Recruited via the Internet

Cited by 117 publications

References 64 publications

Dietary Interventions and Multiple Sclerosis

Dietary Interventions and Multiple Sclerosis

Sexual function in multiple sclerosis and associations with demographic, disease and lifestyle characteristics: an international cross-sectional study

Lifestyle, medication and socio-demographic determinants of mental and physical health-related quality of life in people with multiple sclerosis

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