Predictors of patient-reported fatigue symptom severity in a nationwide multiple sclerosis cohort
(2023) In Multiple Sclerosis and Related Disorders 70.- Abstract
Background: Fatigue is a debilitating symptom of multiple sclerosis (MS), but its relation to sociodemographic and disease-related characteristics has not been investigated in larger studies. The objectives of this study were to evaluate predictors of self-reported fatigue in a Swedish nationwide register-based MS cohort. Methods: Using a repeated cross-sectional design, we included 2,165 persons with relapsing- remitting and secondary progressive MS with one or multiple Fatigue Scale for Motor and Cognitive Functions (FSMC) scores, which was modelled using multivariable linear regressions for multiple predictors. Results: Only associations to expanded disability status scale (EDSS) and Symbol Digit Modalities Test (SDMT) were... (More)
Background: Fatigue is a debilitating symptom of multiple sclerosis (MS), but its relation to sociodemographic and disease-related characteristics has not been investigated in larger studies. The objectives of this study were to evaluate predictors of self-reported fatigue in a Swedish nationwide register-based MS cohort. Methods: Using a repeated cross-sectional design, we included 2,165 persons with relapsing- remitting and secondary progressive MS with one or multiple Fatigue Scale for Motor and Cognitive Functions (FSMC) scores, which was modelled using multivariable linear regressions for multiple predictors. Results: Only associations to expanded disability status scale (EDSS) and Symbol Digit Modalities Test (SDMT) were considered clinically meaningful among MS-associated characteristics in our main model; compared to mild disability (EDSS 0-2.5), those with severe disability (EDSS ≥6) scored 17.6 (95% CI 13.1-22.2) FSMC points higher, while the difference was 10.7 (95% CI 8.0-13.4) points for the highest and lowest quartiles of SDMT. Differences between highest and lowest quartiles of health-related quality of life (HRQoL) instruments were even greater and considered clinically meaningful; EuroQoL Visual Analogue Scale (EQ-VAS) 31.9 (95% CI 29.9-33.8), Multiple Sclerosis Impact Scale (MSIS-29) psychological component 35.6 (95% CI 33.8-37.4) and MSIS-29 physical component 45.5 (95% CI 43.7-47.4). Conclusion: Higher self-reported fatigue is associated with higher disability level and worse cognitive processing speed, while associations to other MS-associated characteristics including MS type, line of disease modifying therapy (DMT), MS duration, relapse and new cerebral lesions are weak. Furthermore, we found a strong correlation between high fatigue rating and lower ratings on health-related quality of life instruments.
(Less)
- author
- organization
- publishing date
- 2023-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cohort studies, Comorbidity, Fatigue, Health-related quality of life, Multiple sclerosis, Quality of life
- in
- Multiple Sclerosis and Related Disorders
- volume
- 70
- article number
- 104481
- publisher
- Elsevier
- external identifiers
-
- scopus:85146029879
- pmid:36603296
- ISSN
- 2211-0348
- DOI
- 10.1016/j.msard.2022.104481
- language
- English
- LU publication?
- yes
- id
- 83467911-3608-4dbf-8e62-081b5eb04f39
- date added to LUP
- 2023-02-16 16:43:00
- date last changed
- 2024-09-15 19:17:22
@article{83467911-3608-4dbf-8e62-081b5eb04f39, abstract = {{<p>Background: Fatigue is a debilitating symptom of multiple sclerosis (MS), but its relation to sociodemographic and disease-related characteristics has not been investigated in larger studies. The objectives of this study were to evaluate predictors of self-reported fatigue in a Swedish nationwide register-based MS cohort. Methods: Using a repeated cross-sectional design, we included 2,165 persons with relapsing- remitting and secondary progressive MS with one or multiple Fatigue Scale for Motor and Cognitive Functions (FSMC) scores, which was modelled using multivariable linear regressions for multiple predictors. Results: Only associations to expanded disability status scale (EDSS) and Symbol Digit Modalities Test (SDMT) were considered clinically meaningful among MS-associated characteristics in our main model; compared to mild disability (EDSS 0-2.5), those with severe disability (EDSS ≥6) scored 17.6 (95% CI 13.1-22.2) FSMC points higher, while the difference was 10.7 (95% CI 8.0-13.4) points for the highest and lowest quartiles of SDMT. Differences between highest and lowest quartiles of health-related quality of life (HRQoL) instruments were even greater and considered clinically meaningful; EuroQoL Visual Analogue Scale (EQ-VAS) 31.9 (95% CI 29.9-33.8), Multiple Sclerosis Impact Scale (MSIS-29) psychological component 35.6 (95% CI 33.8-37.4) and MSIS-29 physical component 45.5 (95% CI 43.7-47.4). Conclusion: Higher self-reported fatigue is associated with higher disability level and worse cognitive processing speed, while associations to other MS-associated characteristics including MS type, line of disease modifying therapy (DMT), MS duration, relapse and new cerebral lesions are weak. Furthermore, we found a strong correlation between high fatigue rating and lower ratings on health-related quality of life instruments.</p>}}, author = {{Englund, Simon and Kierkegaard, Marie and Burman, Joachim and Fink, Katharina and Fogdell-Hahn, Anna and Gunnarsson, Martin and Hillert, Jan and Langer-Gould, Annette and Lycke, Jan and Nilsson, Petra and Salzer, Jonatan and Svenningsson, Anders and Mellergård, Johan and Olsson, Tomas and Longinetti, Elisa and Frisell, Thomas and Piehl, Fredrik}}, issn = {{2211-0348}}, keywords = {{Cohort studies; Comorbidity; Fatigue; Health-related quality of life; Multiple sclerosis; Quality of life}}, language = {{eng}}, publisher = {{Elsevier}}, series = {{Multiple Sclerosis and Related Disorders}}, title = {{Predictors of patient-reported fatigue symptom severity in a nationwide multiple sclerosis cohort}}, url = {{http://dx.doi.org/10.1016/j.msard.2022.104481}}, doi = {{10.1016/j.msard.2022.104481}}, volume = {{70}}, year = {{2023}}, }