Identification of cognitive impairment, depression, and fatigue among multiple sclerosis patients in a large comprehensive care center: A mixed-methods, qualitative study

Tornatore, Carlo; Ahmad, Alexis; Pham, Timothy; Gupte-Singh, Komal; Wahid, Naila; Lynch, Joseph P.; Pratt, Kelsey Jones

doi:10.1016/j.msard.2022.104117

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Both situations can considerably limit Qo. Therefore, to determine the impact of CI in isolation on QoL in these patients, cases of MS that occur with CI should be separated from those who also have fatigue and/or depression, or studies should proceed to a stratified analysis of patients (in the presence or absence of these situations) [ 92 , 93 , 94 ].…”

Section: Limitationsmentioning

confidence: 99%

Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients—A Comprehensive Review

Gómez-Melero,

Caballero-Villarraso,

Escribano

et al. 2024

JCM

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Multiple sclerosis (MS) is characterized by a variety of symptoms that have a major impact on quality of life (QoL) even in early stages. In addition to individual motor, sensory, visual disturbances, and brainstem and sphincter disorders, which are expressed through the widely used Expanded Disability Status Scale (EDSS), other manifestations of MS have a detrimental effect on overall functioning and quality of life, such as cognitive impairment, depression, anxiety, fatigue, and pain. However, when talking about QoL, categorical definitions cannot be used because although the concept is generally understood, it is highly nuanced. Suffering from MS can significantly reduce QoL. Numerous research studies have focused on trying to identify and assess which are the elements that most affect the loss of QoL in MS people. However, in addition to the fact that the measurement of QoL can be subjective, it is very difficult to consider these elements in isolation, as they are interrelated. One such limiting factor of QoL that has been investigated is cognitive impairment (CI). This has been shown to have an impact on the lives of MS people, although the different approaches that have been taken to assess CI have evident limitations.

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Section: Limitationsmentioning

confidence: 99%

Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients—A Comprehensive Review

Gómez-Melero,

Caballero-Villarraso,

Escribano

et al. 2024

JCM

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“…Professional team members should be capable of recognizing the depressive symptoms, and these symptoms should be taken into account when planning patient care. However, standardized screening tools are used infrequently because of the lack of support staff (Tornatore et al, 2022). Screening for depression should be an ongoing part of the therapeutic process, especially when patients are undergoing DMT treatment because patients characterized by depressive symptoms are less adhere to therapeutic recommendations (Kołtuniuk and Rosińczuk, 2021).…”

Section: Depression and Its Impact On The Quality Of Lifementioning

confidence: 99%

The quality of life in patients with multiple sclerosis – Association with depressive symptoms and physical disability: A prospective and observational study

et al. 2023

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BackgroundPatients with multiple sclerosis (MS) experience disabilities which significantly affect their quality of life (QOL) and mental health. Mood disorders and depressive symptoms are one of the most common psychiatric conditions in MS patients. This study aimed to evaluate the level of QOL in MS patients and to assess the influence of depressive symptoms and physical disability on QOL.MethodsThis prospective and observational study was conducted among 100 MS patients (mean age of 36.23 ± 11.77) recruited from the Lower Silesian Unit of the Polish Association for Multiple Sclerosis. This study used a questionnaire designed by the authors, which contained questions about sociodemographic and clinical data, as well as the following standardized questionnaires: the Activities of Daily Living questionnaire (ADL), the Instrumental Activities of Daily Living questionnaire (IADL), the Expanded Disability Status Scale (EDSS), the Beck Depression Inventory (BDI) and Multiple Sclerosis International Quality of Life Questionnaire (MusiQOL).ResultsThe average EDSS score among patients was 3.13 ± 2.38 points. More than half of the respondents (68%) suffered from depression of varying severity. The univariate linear regression models showed that the independent (p < 0.05) QOL predictors (total MusiQOL) were as follows: the number of complaints, IADL results, BDI results, EDSS score, higher education, and material status >2000 PLN. In addition, the multiple linear regression model showed that the BDI result was a significant predictor of QOL (p < 0.005).ConclusionDepressive symptoms significantly affect the QOL of MS patients.

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Improving Parkinson's Disease Care through Systematic Screening for Depression

Marras,

Meyer,

Liu

et al. 2024

Movement Disord Clin Pract

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BackgroundDepression is common in Parkinson's disease (PD) but is underrecognized clinically. Although systematic screening is a recommended strategy to improve depression recognition in primary care practice, it has not been widely used in PD care.MethodsThe 15‐item Geriatric Depression Scale (GDS‐15) was implemented at 5 movement disorders clinics to screen PD patients. Sites developed processes suited to their clinical workflow. Qualitative interviews with clinicians and patients provided information on feasibility, acceptability, and perceived utility.ResultsPrior to implementation, depression screening was recorded in 12% using a formal instrument; 64% were screened informally by clinical interview, and no screening was recorded in 24%. Of 1406 patients seen for follow‐up care during the implementation period, 88% were screened, 59% using the GDS‐15 (self‐administered in 51% and interviewer administered in 8%), a nearly 5‐fold increase in formal screening. Lack of clinician or staff time and inability to provide the GDS‐15 to the patient ahead of the visit were the most commonly cited reasons for lack of screening using the GDS‐15; 378 (45%) patients completing the GDS‐15 screened positive for depression, and 137 were enrolled for a 12‐month prospective follow‐up. Mean GDS‐15 scores improved from 8.8 to 7.0 (P < 0.0001) and the 39‐item Parkinson's Disease Questionnaire emotional subscore from 42.2 to 36.7 (P = 0.0007).ConclusionsDepression screening in PD using a formal instrument can be achieved at much higher levels than is currently practiced, but there are barriers to implementing this in clinical practice. An individual site‐specific process is necessary to optimize screening rates.

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Identification of cognitive impairment, depression, and fatigue among multiple sclerosis patients in a large comprehensive care center: A mixed-methods, qualitative study

Cited by 5 publications

References 16 publications

Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients—A Comprehensive Review

Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients—A Comprehensive Review

The quality of life in patients with multiple sclerosis – Association with depressive symptoms and physical disability: A prospective and observational study

Improving Parkinson's Disease Care through Systematic Screening for Depression

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