Cognition and Physical Disability in Predicting Health-Related Quality of Life in Multiple Sclerosis

Many studies have shown that multiple sclerosis (MS) has a significant impact on patient health-related quality of life (HRQOL), but the relative contributions of physical versus cognitive disability are not well established. Most studies have relied on HRQOL outcomes that depend largely on patient mood, life satisfaction, and personal happiness. The Sickness Impact Profile (SIP) is a measure of HRQOL known for its relatively strong emphasis on task completion and activities of daily living. As such, the SIP may be less influenced by depression. We sought to determine the relative influence of physical disability and cognition, above and beyond demographic and disease variables, in predicting HRQOL. Patients (n = 132) and healthy controls (n = 26) underwent complete neuropsychological evaluation using the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery and a series of self-report measures assessing depression, fatigue, and HRQOL. The SIP was also administered. Correlation analysis and group comparisons revealed significant associations between cognition and HRQOL outcomes. Logistic regression models comparing the Expanded Disability Status Scale (EDSS) and cognitive tests in predicting poor physical HRQOL retained both EDSS and Symbol Digit Modalities Test (SDMT) performance, while models predicting poor psychosocial and poor overall HRQOL retained only the SDMT. These findings support cognition as a significant predictor of overall HRQOL, psychosocial HRQOL, and, interestingly, physical HRQOL.

Download Full-text

Factors Associated with Health-Related Quality of Life Among Older People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2012-046 ◽

2014 ◽

Vol 16 (1) ◽

pp. 10-19 ◽

Cited By ~ 10

Author(s):

Marijean Buhse ◽

Wendy M. Banker ◽

Lynn M. Clement

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Physical Disability ◽

Health Related Quality ◽

Neurologic Impairment ◽

Related Quality ◽

Health Related ◽

Mental Hrqol ◽

Physical Hrqol

Background: This study was conducted to determine which factors (clinical and demographic) are associated with mental and physical health-related quality of life (HRQOL) among people with multiple sclerosis (MS) aged 60 years and older. Methods: Data were collected at four MS centers on Long Island, New York, from a total of 211 patients. Three surveys were administered that collected demographic information and included validated questionnaires measuring quality of life (QOL), cognition, depression, and disability. Multivariate linear regression analyses examined the relationship between patient demographics and scores on standardized scales measuring mental and physical HRQOL (Multiple Sclerosis Quality of Life–54). Variables included in the regression models were selected on the basis of the Andersen Healthcare Utilization model. This framework encompasses the multiple influences on health status, including predisposing characteristics, enabling resources, need, and health behavior. Results: We found that mental HRQOL was negatively associated with having a high school education or less, risk of neurologic impairment, physical disability, and depression. No variables were positively associated with mental HRQOL. Physical HRQOL was negatively associated with risk of neurologic impairment, physical disability, depression, and the comorbidity of thyroid disease. However, patient employment and, surprisingly, being widowed were positively associated with physical HRQOL. These findings are consistent with those of similar studies among younger patients in which lower HRQOL was associated with increased disability, depression, risk of neurologic impairment, and lower levels of education. Conclusions: The findings that patient employment and being widowed were associated with better physical HRQOL suggest that older patients have the ability to adapt and adjust to the challenges of MS over time. Clinicians should regularly screen for HRQOL in older patients with MS.

Download Full-text

Pediatric-onset multiple sclerosis is associated with reduced parental health–related quality of life and family functioning

Multiple Sclerosis Journal ◽

10.1177/1352458518796676 ◽

2018 ◽

Vol 25 (12) ◽

pp. 1661-1672 ◽

Cited By ~ 4

Author(s):

Julia O’Mahony ◽

Ruth Ann Marrie ◽

Audrey Laporte ◽

Amit Bar-Or ◽

E Ann Yeh ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Family Functioning ◽

Disease Onset ◽

Self Report ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

Background: Diagnosis of multiple sclerosis (MS) during childhood has the potential to impact the affected child’s self-perception and the health-related quality of life (HRQoL) of the family. Objective: To evaluate the impact of chronic disease, in children ascertained as having MS and their families, when compared to those with monophasic acquired demyelinating syndrome (monoADS). Methods: In a national prospective cohort study of pediatric acquired demyelinating syndromes (ADS), the HRQoL of children and their families was captured using the Pediatric Quality of Life Inventory (PedsQL™) Modules. Results: Participants (58 MS; 178 monoADS) provided cross-sectional HRQoL data a median (interquartile range (IQR)) of 4.1 (2.0–6.0) years after disease onset. The HRQoL of parents of children with MS and their family functioning was lower when compared to that of parents and families of children with monoADS (both p < 0.001); parents of children with MS reported greater emotional dysfunction, worry, worse communication, and lower family functioning irrespective of clinical disease activity. Self-reports of the MS and monoADS participants did not suggest a difference in overall HRQoL or fatigue after adjusting for age of the child at the time of assessment. Conclusion: While children with MS did not self-report lower HRQoL compared to children who experienced monoADS, the diagnosis of MS during childhood was negatively associated with parental HRQoL and family functioning.

Download Full-text

Health-related quality of life in secondary progressive multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/13524585070130030101 ◽

2007 ◽

Vol 13 (3) ◽

pp. 386-392 ◽

Cited By ~ 35

Author(s):

A.G. Beiske ◽

H. Naess ◽

J.H. Aarseth ◽

O. Andersen ◽

I. Elovaara ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Disease Progression ◽

Physical Disability ◽

Health Related Quality ◽

Secondary Progressive ◽

Related Quality ◽

Health Related ◽

Sum Scores

Common disability scales in multiple sclerosis (MS) are often weighted towards physical disability. Non-motor symptoms such as depression, fatigue and pain substantially influence wellbeing in MS. Health-related quality of life (HRQoL) measures the broader impact of MS and might indicate less obvious disease burdens. We analysed HRQoL, using the Nottingham Health Profile Part I (NHP-I), among 345 secondary progressive MS (SPMS) patients participating in a randomized trial of interferon-β1a (IFN-β1a), 22 μg subcutaneously weekly, or matching placebo. The results did not reveal any beneficial effect of IFN-β1a in any outcome measure. NHP-I sub- and sum scores were compared for 217 population controls and correlated with demographic and clinical disease variables. SPMS patients had lower NHP-I sum and all subscores than the controls. Patients experiencing disease progression reported worse NHP-I sum scores. Increased fatigue, Expanded Disability Status Scale (EDSS) and Arm Index scores were independently associated with reduction in several NHP-I subscores. SPMS patients had significantly lower HRQoL than controls and physical disability (EDSS and Arm Index), disease progression and fatigue strongly influenced this. MS

Download Full-text

Workplace difficulties, health-related quality of life and perception of stigma in people with multiple sclerosis with low physical disability

10.26226/morressier.5b719e445aff74008ae4ce76 ◽

2018 ◽

Author(s):

Jose Manuel Garcia Dominguez ◽

Nicolas Medrano

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Physical Disability ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Download Full-text

The Vietnamese Version of the Health-related Quality of Life Measure for Children with Epilepsy (CHEQOL-25): Reliability

MedPharmRes ◽

10.32895/ump.mpr.1.1.9/suffix ◽

2017 ◽

Vol 1 (1) ◽

pp. 9-14

Author(s):

Tri Doan ◽

Tuan Tran ◽

Han Nguyen ◽

◽

...

Keyword(s):

Quality Of Life ◽

Good Practice ◽

The Self ◽

Self Report ◽

Health Related Quality ◽

Life Measure ◽

Related Quality ◽

Health Related ◽

Parent Proxy

Purpose: This study aimed to translate and culturally adapt the self-report and parent-proxy Health-Related Quality of Life Measure for Children with Epilepsy (CHEQOL-25) into Vietnamese and to evaluate their reliability. Methods: Both English versions of the self-report and parent-proxy CHEQOL-25 were translated and culturally adapted into Vietnamese by using the Principles of Good Practice for the Translation and Cultural Adaptation Process. The Vietnamese versions were scored by 77 epileptic patients, who aged 8–15 years, and their parents/caregivers at neurology outpatient clinic of Children Hospital No. 2 – Ho Chi Minh City. Reliability of the questionnaires was determined by using Cronbach’s coefficient α and intra-class correlation coefficient (ICC). Results: Both Vietnamese versions of the self-report and parent-proxy CHEQOL-25 were shown to be consistent with the English ones, easy to understand for Vietnamese children and parents. Thus, no further modification was required. Cronbach’s α coefficient for each subscale of the Vietnamese version of the self-report and parent-proxy CHEQOL-25 was 0.65 to 0.86 and 0.83 to 0.86, respectively. The ICC for each subscale of the self-report and parent-proxy CHEQOL-25 was in the range of 0.61 to 0.86 and 0.77 to 0.98, respectively. Conclusion: The Vietnamese version of the self-report and parent-proxy CHEQOL-25 were the first questionnaires about quality of life of epileptic children in Vietnam. This Vietnamese version was shown to be reliable to assess the quality of life of children with epilepsy aged 8–15 years.

Download Full-text

Coping strategies, health-related quality of life and life satisfaction among persons with multiple sclerosis

10.26226/morressier.59a3eda9d462b8028d895a09 ◽

2017 ◽

Author(s):

Marta Bassi

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Life Satisfaction ◽

Coping Strategies ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Download Full-text

Long-Term Effectiveness of Fingolimod for Multiple Sclerosis in a Real-World Clinical Setting

European Neurology ◽

10.1159/000514828 ◽

2021 ◽

pp. 1-6

Author(s):

Cihat Uzunköprü ◽

Yesim Beckmann ◽

Sabiha Türe

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Real Life ◽

Life Assessment ◽

Health Related Quality ◽

Serious Adverse Events ◽

Related Quality ◽

Health Related

Introduction: The primary aim of the present study was to evaluate the long-term efficacy of fingolimod in patients with multiple sclerosis (MS); secondary aims were to describe the safety of fingolimod with the evaluation of treatment satisfaction and impact on the quality of life in real life. Methods: We collected clinical, demographical, neuroradiological, and treatment data, including pre- and posttreatment status health-related quality of life from 286 MS patients consecutively treated with fingolimod. Clinical assessment was based on the Expanded Disability Status Scale (EDSS), and quality of life assessment was performed with MS-related quality of life inventory (MSQOLI). The data were recorded at baseline and every 6 months for 2 years. Results: One hundred and fourteen males and 172 females were enrolled. The annualized relapse rate and EDSS showed a statistically significant reduction during the observation period (p < 0.001). The patients also demonstrated substantial improvements in magnetic resonance imaging (MRI) outcomes (p < 0.001). Health-related quality of life scores improved significantly between baseline and 24-month visit (p < 0.001). No serious adverse events occurred. Conclusion: In our cohort, fingolimod treatment was associated with reduced relapse, MRI activity, and improved EDSS and MSQOLI scores. Additionally, fingolimod has been able to maintain its effectiveness over a considerable long period of treatment.

Download Full-text

Effects of BG-12 (dimethyl fumarate) on health-related quality of life in patients with relapsing–remitting multiple sclerosis: findings from the CONFIRM study

Multiple Sclerosis Journal ◽

10.1177/1352458513507818 ◽

2013 ◽

Vol 20 (2) ◽

pp. 253-257 ◽

Cited By ~ 26

Author(s):

Mariko Kita ◽

Robert J Fox ◽

J Theodore Phillips ◽

Michael Hutchinson ◽

Eva Havrdova ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Short Form ◽

Dimethyl Fumarate ◽

Phase Iii ◽

Health Related Quality ◽

Relapsing Remitting ◽

Related Quality ◽

Health Related

Multiple sclerosis (MS) has a significant impact on health-related quality of life (HRQoL) with symptoms adversely affecting many aspects of everyday living. BG-12 (dimethyl fumarate) demonstrated significant efficacy in the phase III studies DEFINE and CONFIRM in patients with relapsing–remitting MS. In CONFIRM, HRQoL was worse in patients with greater disability at baseline, and who relapsed during the study, and improved with BG-12 treatment. Mean Short Form-36 Physical Component Summary scores for BG-12 increased over 2 years and scores for placebo decreased. Coupled with clinical and neuroradiological benefits, these HRQoL results further support BG-12 as an effective oral treatment for relapsing MS.

Download Full-text