Associations between smoking and walking, fatigue, depression, and health-related quality of life in persons with multiple sclerosis

Kahraman, Turhan; Özdoğar, Asiye Tuba; Abasıyanık, Zuhal; Özakbaş, Serkan

doi:10.1007/s13760-020-01341-2

Cited by 27 publications

(41 citation statements)

References 50 publications

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“…A recent study reported that non-smoking was associated with a lower impact of fatigue on total functioning when assessed by the MFIS (Kahraman et al, 2020). This is in accordance with the results of the present study where current smoking was associated with higher scores of fatigue impact on total, physical and psychosocial functioning (Table 2).…”

Section: Discussionsupporting

confidence: 93%

“…However, in the regression analyses the contribution to fatigue impact was significant for psychosocial functioning only. The results from our study and the study by Kahraman et al (Kahraman et al, 2020) imply that tobacco smoking influences fatigue in MS patients, but the specific aspects that are influenced need to be confirmed. Additionally, the negative influence of tobacco smoking even on disease progression has previously been shown (Hedstrom et al, 2013), which further highlights the importance of supporting smoking cessation.…”

Section: Discussionmentioning

confidence: 48%

“…In people with MS it has been found that modifiable lifestyle factors such as physical activity (Motl and Pilutti, 2012;Reider et al, 2017), diet (Hadgkiss et al, 2015;Strober et al, 2018), body mass index (Leong et al, 2018;Marck et al, 2016), alcohol intake (Weiland et al, 2014), tobacco smoking (Weiland et al, 2014;Di Pauli et al, 2008;Kahraman et al, 2020), social support (Schwartz and Frohner, 2005) and engagement in social activities (Pittion-Vouyovitch et al, 2006;D'hooghe et al, 2013) are associated with quality of life, and studies have suggested that a healthy lifestyle behavior influence disease progression (D'hooghe et al, 2013;Stuifbergen et al, 2006). Increased physical exercise (Pilutti et al, 2013;Bansi et al, 2013;Kierkegaard et al, 2016), better diet (Albrechtsen et al, 2020) and non-smoking (Kahraman et al, 2020) have shown potential to reduce fatigue, whereas no association has been reported for alcohol intake (Bombardier et al, 2004). Recently, a large-numbered study (n = 6989) reported that a combination of lifestyle factors (a composite implying adherence to better diet, lower body mass index, non-smoking, and engagement in physical activity) contributed to reduced fatigue (Fitzgerald et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Associations between fatigue impact and lifestyle factors in people with multiple sclerosis – The Danish MS hospitals rehabilitation study

Johansson

Skjerbæk

Nørgaard

et al. 2021

Multiple Sclerosis and Related Disorders

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Background:The lack of medical treatment options to reduce fatigue in patients with multiple sclerosis (MS) emphasize the importance of identifying potential non-pharmacological modifiable factors, as this may help advance current treatment strategies. The aim of this study was to identify potential modifiable lifestyle factors as well as patient-and disease-related characteristics, that are associated with fatigue in a large sample of clinically well-characterized patients with MS.Methods: This study was a secondary analysis of a pragmatic randomized controlled trial of inpatient multidisciplinary rehabilitation in Denmark. MS patients aged 18 to 65 years and with a disease severity score ≤ 7.5 according to the Expanded Disability Status Scale participated. Data on patient-and disease-related characteristics, fatigue impact (Modified Fatigue Impact Scale (MFIS)), and on lifestyle factors (tobacco smoking, alcohol intake, and physical activity), were collected at baseline.A linear mixed model was used to compare MFIS total, physical, cognitive, and psychosocial scores across subgroups of selected characteristics. Regression analyses were used to examine associations between lifestyle factors and MFIS total, physical, cognitive, and psychosocial scores.Results: In the sample of 417 MS patients, median age was 51 years, 69% were female, median time since diagnosis was 8 years, with 41% having relapsing remitting MS.Higher MFIS total scores were observed in MS patients with shorter time since diagnosis, being a tobacco smoker, and not undertaking regular physical activity. Somewhat similar findings were observed for MFIS subscores (physical, cognitive, psychosocial), especially MFIS physical scores.In the multivariate analyses, physical activity was significantly associated with fatigue impact on total, physical and psychosocial functioning. Tobacco smoking was significantly associated with fatigue impact on psychosocial functioning. Alcohol intake was not associated with fatigue impact. None of the lifestyle factors were associated with fatigue impact on cognitive functioning. In the adjusted models time since diagnosis was significantly associated with fatigue impact on total, physical and cognitive functioning, as was disease severity with fatigue impact on physical and cognitive functioning.Conclusion: Physical activity showed the most pronounced associations with fatigue impact on physical and psychosocial functioning, while the impact on cognitive functioning showed a trend. Tobacco smoking contributed significantly to impact on psychosocial functioning, while alcohol intake did not contribute to fatigue impact. Introducing or supporting maintenance of physical activity/exercise and cessation of tobacco smoking seems to be a useful approach for rehabilitation services to help patients with MS manage fatigue.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between fatigue impact and lifestyle factors in people with multiple sclerosis – The Danish MS hospitals rehabilitation study

Johansson

Skjerbæk

Nørgaard

et al. 2021

Multiple Sclerosis and Related Disorders

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“…Besides these predisposing factors, modifiable factors such as depressed mood and anxiety may be associated with, or maintain, fatigue in specific chronic diseases 6 , 27 – 30 . Also, lower physical activity levels 31 – 33 , sleep disturbances 7 , lower body mass index (BMI) 34 , hyper- or hypotension 35 , 36 , pain 6 , 28 , 37 , 38 , and smoking status 39 , 40 have been identified as factors possibly contributing to fatigue in specific chronic diseases.…”

Section: Introductionmentioning

confidence: 99%

Fatigue in patients with chronic disease: results from the population-based Lifelines Cohort Study

Goërtz¹,

Braamse

Spruit³

et al. 2021

Sci Rep

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Abstract(1) To evaluate the prevalence of severe and chronic fatigue in subjects with and without chronic disease; (2) to assess to which extent multi-morbidity contributes to severe and chronic fatigue; and (3) to identify predisposing and associated factors for severe and chronic fatigue and whether these are disease-specific, trans-diagnostic, or generic. The Dutch Lifelines cohort was used, including 78,363 subjects with (n = 31,039, 53 ± 12 years, 33% male) and without (n = 47,324, 48 ± 12 years, 46% male) ≥ 1 of 23 chronic diseases. Fatigue was assessed with the Checklist Individual Strength-Fatigue. Compared to participants without a chronic disease, a higher proportion of participants with ≥ 1 chronic disease were severely (23% versus 15%, p < 0.001) and chronically (17% versus 10%, p < 0.001) fatigued. The odds of having severe fatigue (OR [95% CI]) increased from 1.6 [1.5–1.7] with one chronic disease to 5.5 [4.5–6.7] with four chronic diseases; for chronic fatigue from 1.5 [1.5–1.6] to 4.9 [3.9–6.1]. Multiple trans-diagnostic predisposing and associated factors of fatigue were found, explaining 26% of variance in fatigue in chronic disease. Severe and chronic fatigue are highly prevalent in chronic diseases. Multi-morbidity increases the odds of having severe and chronic fatigue. Several trans-diagnostic factors were associated with fatigue, providing a rationale for a trans-diagnostic approach.

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“…Palenie było też związane z wyraźniejszym zmniejszeniem frakcji istoty szarej (Graetz et al, 2019). W badaniu z udziałem 279 chorych palący mieli znacznie bardziej nasilone objawy zmęczenia i depresji oraz niższą jakość życia związaną ze zdrowiem w porównaniu z niepalącymi (Kahraman et al, 2020). W metaanalizie badań dotyczących wpływu palenia na przebieg SM wykazano, że palenie tytoniu jest istotnie związane z wyższym wynikiem w skali EDSS, ale nie ma istotnego związku z ryzykiem osiąg nięcia EDSS 4 lub EDSS 6.…”

Section: Omówienieunclassified

The relationship between smoking and disease activity in patients with relapsing-remitting multiple sclerosis on immunomodulatory therapy

Rakoca¹,

Tywoniuk²

2020

Aktualn Neurol

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Wstęp: W ostatnich doniesieniach zauważono negatywny wpływ palenia tytoniu na rozwój i przebieg stwardnienia rozsianego. Cel: Celem badania wieloośrodkowego (Bydgoszcz, Zabrze, Białystok, Szczecin) była analiza związku między paleniem tytoniu a aktywnością choroby u pacjentów ze stwardnieniem rozsianym leczonych lekami immunomodulującymi. Materiał i metoda: W badaniu uwzględniono dane demograficzne i kliniczne: płeć, wiek, palenie tytoniu (paczkolata), czas leczenia, stan niepełnosprawności w skali EDSS (Expanded Disability Status Scale, Rozszerzona Skala Niepełnosprawności Ruchowej). Ponadto określano aktywność choroby -poprzez ocenę rocznego wskaźnika rzutów (annualised relapse rate, ARR) po roku i 2 latach leczenia oraz aktywność choroby w badaniu rezonansu magnetycznego. Dane te poddano analizie statystycznej. Wyniki: Badana grupa objęła 114 chorych -57 (50%) osób niepalących i 57 (50%) palących. Średni czas leczenia wynosił 2,46 (±1,23) roku, średnia wartość EDSS -2,12 (±1,03) pkt, ARR w momencie rozpoczęcia terapii -1,46 w grupie osób palących i 1,36 wśród niepalących. Nowe zmiany demielinizacyjne w rezonansie magnetycznym po roku leczenia stwierdzono u 15 (26,3%) pacjentów palących i u 8 (14%) niepalących. Analiza statystyczna wykazała istotne zależności między paleniem tytoniu a nowymi zmianami w rezonansie magnetycznym w mózgowiu po roku leczenia (r = −0,21, p < 0,05). Wnioski: U osób palących leczonych immunomodulująco w porównaniu z osobami niepalącymi obserwuje się wyraźną progresję radiologiczną choroby w pierwszych 2 latach leczenia. Słowa kluczowe: stwardnienie rozsiane, leczenie immunomodulacyjne, nikotynizmIntroduction: Recent reports have shown that smoking has a negative impact on the development and course of multiple sclerosis. Aim: The aim of this multicentre (Bydgoszcz, Zabrze, Białystok, Szczecin) study was to analyse the relationship between smoking and disease activity in patients with relapsing-remitting multiple sclerosis on immunomodulatory therapy. Materials and methods: We evaluated demographic and clinical data, such as sex, age, smoking (pack-years), treatment duration, disability status according to the Expanded Disability Status Scale (EDSS). Furthermore, we determined disease activity based on both the annualised relapse rate (ARR) after one and 2 years of treatment and magnetic resonance imaging findings. The obtained data were analysed statistically. Results: The study group included 114 patients: 57 (50%) non-smokers and 57 (50%) smokers. Mean treatment duration was 2.46 (±1.23) years, mean EDSS was 2.12 (±1.03), and ARR at treatment initiation was 1.46 in smokers vs. 1.36 in non-smokers. New magnetic resonance demyelination lesions were found after 1 year of treatment in 15 (26.3%) smokers and 8 (14%) non-smokers. Statistical analysis showed significant relationships between smoking and new cerebral lesions in magnetic resonance imaging (r = −0.21, p < 0.05). Conclusions: Smokers on immunomodulatory therapy show marked radiological progression of the disease in the first 2 ...

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Associations between smoking and walking, fatigue, depression, and health-related quality of life in persons with multiple sclerosis

Cited by 27 publications

References 50 publications

Associations between fatigue impact and lifestyle factors in people with multiple sclerosis – The Danish MS hospitals rehabilitation study

Associations between fatigue impact and lifestyle factors in people with multiple sclerosis – The Danish MS hospitals rehabilitation study

Fatigue in patients with chronic disease: results from the population-based Lifelines Cohort Study

The relationship between smoking and disease activity in patients with relapsing-remitting multiple sclerosis on immunomodulatory therapy

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