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Predictors of patient-reported fatigue symptom severity in a nationwide multiple sclerosis cohort

Englund, Simon ; Kierkegaard, Marie ; Burman, Joachim ; Fink, Katharina ; Fogdell-Hahn, Anna ; Gunnarsson, Martin ; Hillert, Jan ; Langer-Gould, Annette ; Lycke, Jan and Nilsson, Petra LU , et al. (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.

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organization
publishing date
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
  • pmid:36603296
  • scopus:85146029879
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
2024-06-09 10:12:57
@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}},
}