Estimating the relative contribution of comorbidities in predicting health-related quality of life of people with multiple sclerosis

Abstract

Background:Little is known about the relative contribution of comorbidities in predicting the health-related quality of life (HRQoL) of people with Multiple Sclerosis (PwMS).Objective: To determine the associations between the number of and individual comorbidities and HRQoL and estimate the relative contribution of different comorbidities on HRQoL.Methods: Cross-sectional analysis of data on self-reported presence of 30 comorbidities and HRQoL from the Australian MS Longitudinal Study (AMSLS) participants(n=902). HRQoL was measured using the Assessment of Quality of Life-8 Dimensions (AQoL-8D). Linear regression and general dominance analysis were used.Results: Higher number of comorbidities was associated with lower HRQoL (p-trend p<0.01).Comorbidities accounted for 18.1% of the variance in HRQoL. Mental health and musculoskeletal disorders were the strongest contributors to lower HRQoL. Of individual comorbidities, systemic lupus erythematosus (SLE) (β=-0.16(-0.27,-0.05)) and depression (β=-0.15(-0.18,-0.13)) were most strongly associated with overall HRQoL, depression (β=-0.14(-0.16,-0.11)) and anxiety (β=-0.10(-0.13,-0.07)) with psychosocial HRQoL, and SLE (β=-0.18(-0.29,-0.07)), rheumatoid arthritis (β=-0.11(-0.19,-0.02)) and hyperthyroidism (β=-0.11(-0.19,-0.03)) with physical HRQoL. Conclusions:Comorbidities potentially make important contributions to HRQoL in PwMS.Our findings highlight groups of and individual comorbidities that could provide the largest benefits for the HRQoL of PwMS if they were targeted for prevention, early detection, and optimal treatment.

Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: A systematic review and meta-analysis

“…The sex distribution was 5605 female patients and 1902 male patients, and the mean age was 45.6 years. Among the methodologies, six studies were cross-sectional ( Kahraman et al, 2021 ; Kowalec et al, 2017 ; Lo, Taylor, Winzenberg, Palmer, Blizzard and van der Mei, 2021a ; Lo, Taylor, Winzenberg, Palmer, Blizzard, Ahmad, et al, 2021b ; Marrie et al, 2018b ; Viana et al, 2015 ), five were prospective cohort studies ( Fiest et al, 2016 ; Marrie, Zhang, et al, 2018a ; McKay et al, 2016 ; Whitehouse et al, 2019 ; Wicks et al, 2016 ) and one was a retrospective cohort study ( Lorefice et al, 2015 ) ( Table 1 ). It was observed that six studies were carried out in North America, two studies in Oceania and four studies in Europe ( Table 1 ).…”

“… Cross-sectional study; No mention of age at MS symptom onset. 7 Lo et al (2021a) MS patients (N = 1518, 55.7 ± 11.3 years, F 1204, M 309) Cross-sectional Australia, Oceania. Treatment: (N = 947); PMS: (N = 150), RRMS: (N = 1113), Unknow: (N = 255); Age at MS symptom onset: 36.0 ± 10.8 years.…”

“…Depression and anxiety affect professional and social interactions, and they can be observed throughout the course of the MS disease ( Tauil et al, 2018 ). There are different types of scales to measure depression and anxiety in the clinic practice, such as Hospital Anxiety and Depression Scale (HADS) ( Julian, 2011 ), Beck's Depression Inventory (BDI), Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS), Structured Clinical Interview (SCID), and International Classification of Diseases (ICD) ( Kahraman et al, 2021 ; Lo, Taylor, Winzenberg, Palmer, Blizzard and van der Mei, 2021a ; Lorefice et al, 2015 ). However, the HADS-type scale is the most found in studies, but the other scales can be used to determine depression and anxiety.…”

Comorbidities contribute substantially to the severity of common multiple sclerosis symptoms

“…Mental health disorders and musculoskeletal disorders had the largest relative contributions to the severity of common symptoms in MS. Interestingly, a companion paper in this issue shows that both mental health and musculoskeletal disorders were also the strongest contributors to lowering the health-related quality of life in people with MS in this same cohort. 25 Mental health disorders (with a diagnosis of depression having the largest individual contribution) had the largest relative contribution to the severity of feelings of anxiety, feelings of depression, cognitive symptoms, sensory symptoms, fatigue and sexual dysfunction. Musculoskeletal disorders (with osteoporosis having the largest individual contribution) had the largest relative contribution to the severity of pain, walking difficulties, difficulty with balance, bladder problems, bowel problems and spasticity.…”

<p>Resveratrol Ameliorates Systemic Sclerosis via Suppression of Fibrosis and Inflammation Through Activation of SIRT1/mTOR Signaling</p>

“… 1 A previous study reported that the quality of a patient’s life was significantly lower than the control group using a SF-36 health questionnaire. 2 The functional damage of patients is gradually aggravated over the prolongation of time. 3 However, the specific pathological mechanism of SSc and its etiological factors remain unclear.…”