Quality of life in multiple sclerosis: the impact of depression, fatigue and disability

Abstract

This study deals with the assessment of quality of life and its main clinical and demographical determinants in a clinical series of 103 patients with multiple sclerosis (MS) (37 men; 66 women; mean age 44.89 years; mean disease duration 12.40 years; mean EDSS score 4.07). We used the MSQOL-54 inventory, a disease-specific instrument recently validated in an Italian population. Each patient underwent a complete clinical assessment, including that of disability status (Expanded Disability Status Scale), cognitive function (Mini Mental State Examination), depression (Hamilton Rating Scale for Depression) and fatigue (Fatigue Severity Scale). In terms of Pearson's correlations, there was a moderate inverse relationship between disability level and the MSQOL-54 physical composite score, and a moderate to strong inverse correlation between depression or fatigue severity and both the physical and mental composite scores. In a stepwise linear regression analysis, depression, fatigue and disability level were confirmed to be significant and independent predictors of quality of life. Quality of life instruments can help to provide a broader measure of the disease impact and to develop a care program tailored to the patient's needs.

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

“…Enrolled patients received natalizumab (300 mg intravenously every 4 weeks) and completed evaluations of fatigue and cognition at three visits at least 7 days apart, including the baseline visit, prior to initiating natalizumab therapy and at weeks 4,8,12,24, and 48 after initiating natalizumab treatment. The primary endpoint was change in VAS-F score 12 weeks after initiating treatment with natalizumab.…”

“…2 It is associated with a perception of impaired general health, mental state, and quality of life (QOL) and may have a stronger effect on QOL than physical disability alone. 4,5 Cognitive impairment, reported in up to 70% of MS patients, may result from fatigue and/or neurologic gram. Exclusion criteria included primary progressive or secondary progressive MS without relapses, prior or current clinically significant medical illness or laboratory abnormality (including progressive multifocal leukoencephalopathy), and (in female patients) pregnancy, current breastfeeding, or plans to become pregnant.…”

Psychiatric Issues in Multiple Sclerosis

“…Quality of life is significantly lower among depressed MS patients than among non-depressed control patients with MS, even when controlling for factors such as level of neurologic disability and fatigue. [5] Depression adversely affects functional status among patients with MS, such as increased time lost from work. [15] MS patients with depression experience disruption of their social support and family systems beyond what can be attributed to neurologic disease factors alone.…”

Reliability and Validity of PROMIS Cognitive Abilities and Cognitive Concerns Scales Among People with Multiple Sclerosis

“…[1][2][3][4][5][6][7] Cognitive impairment has been observed early in the MS trajectory, making timely clinical assessment key to effective disease management. However, underdiagnosis is a problem, 8 and clinicians need more effective methods to screen quickly for cognitive impairment and monitor cognitive functioning over time.…”