Predictors of Fatigue Impact in Persons With Long-Standing Multiple Sclerosis

Abstract

Background Fatigue is a common experience among persons diagnosed with multiple sclerosis (MS). Fatigue negatively influences quality of life, interferes with activities of daily living, and impairs the ability to maintain gainful employment (Amato et al., 2001; Julian, Vella, Vollmer, Hadjimichael, & Mohr, 2008; Smith & Arnett, 2005). Mechanisms underlying the pathophysiologic determinants of fatigue in MS are poorly understood and effective treatments to manage fatigue present a challenge (Krupp, Christodoulou, & Serafin, 2010). While the use of pharmacologic therapies (e.g., Modafinil) is recommended to treat symptomatic fatigue, under-treatment of fatigue is common (Hatzakis et al., 2005; Brichetto, Messmer, Mancarki & Solaro, 2003). Better long-term management and symptomatic relief may be provided by the use of non-pharmacologic treatments such as increased physical activity, energy conservation, and cognitive behavioral therapy (Motl, McAuley & Snook, 2005; van Kessel et al., 2008; McCullagh, Fitzgerald, Murphy, & Cooke, 2008). Methods The purpose of this study was to explore the physical, cognitive and psychosocial dimensions of fatigue impact among persons with longstanding MS - defined here as having been diagnosed with MS for 17 years or more. A sample of 331 participants with MS completed surveys measuring fatigue impact, MS-related functional limitation, depressive symptoms, barriers to health promotion, personal resources, and health promoting behaviors. Results MS-related functional limitation and depressive symptoms were the strongest predictors of fatigue impact. MS-related functional limitation explained the greatest amount of variance in models predicting physical and psychosocial fatigue impact while depressive symptoms explained the most variance in models predicting total and cognitive fatigue impact. Barriers to health promotion explained the least amount of variance among the models. Personal resources and health promoting behaviors were not significant predictors of fatigue impact in this study. Conclusion Interventions aimed at reducing MS-related functional limitations, depressive symptoms, and barriers to health promotion may have beneficial influences on fatigue impact while actions designed to promote personal resource adequacy as well as engagement in health promoting behaviors may not translate into improvements in fatigue impact in persons with MS.

Effect of Self-Care Education on Social Adaptability in Patients with Multiple Sclerosis

“…Fatigue was reported as the most common and disabling complication associated with MS, and its prevalence among participants was dramatically high (19).…”

An Integrative Review of Causes, Manifestations and Evaluation of Cognitive Fatigue among Persons with Multiple Sclerosis

“…Fatigue is the most common disabling symptom in MS affecting over 80% of persons with MS. For many it is the most challenging to manage on a daily basis, and 40% of those with MS consider it their most disabling symptom resulting in decreased quality of life and a significant reason for forfeiture of a vocation or employment (Blikman et al, 2018;Braley & Chervin, 2010;Halper & Harris, 2017;Marshall & Mayer, 2007;Morrison & Stuifbergen et al, 2016;Tedeschi et al, 2007;Touzet, 2017;Vaughn, et al, 2018;Walker et al, 2019). The purpose of this integrative review was to understand new developments about the dimensions of cognitive fatigue, especially its causes and evaluations, in order to detect its manifestations and intervene accordingly.…”

“…The predominant research design used consisted of cohort studies (n=11) using convenience samples from MS centers or clinics. Fatigue was measured through a variety of self-reporting questionnaires and the most frequently used was the Modified Fatigue Impact Scale because it offered a multidimensional assessment (Braley & Chervin, 2010;Colbeck, 2018;Golan et al, 2018;Gullo et al, 2019;Morrison & Stuifbergen, 2016;Vucic et al, 2010). There were three studies that compared scores on self-reporting questionnaires with MRI scans (Sander et al, 2016;Touzet, 2017;Wilting et al, 2016).…”

Untitled

“…Fatigue is the most common disabling symptom in MS affecting over 80% of persons with MS. For many it is the most challenging to manage on a daily basis, and 40% of those with MS consider it their most disabling symptom resulting in decreased quality of life and a significant reason for forfeiture of a vocation or employment (Blikman et al, 2018;Braley & Chervin, 2010;Halper & Harris, 2017;Marshall & Mayer, 2007;Morrison & Stuifbergen et al, 2016;Tedeschi et al, 2007;Touzet, 2017;Vaughn, et al, 2018;Walker et al, 2019). The purpose of this integrative review was to understand new developments about the dimensions of cognitive fatigue, especially its causes and evaluations, in order to detect its manifestations and intervene accordingly.…”