Physical dimension of fatigue correlated with disability change over time in patients with multiple sclerosis

Abstract

To determine the value of fatigue in predicting the change in disability status in patients with multiple sclerosis (MS), we realized a prospective population-based cohort study of 196 patients with clinically definite MS. In 2002, baseline data were collected on fatigue (Modified Fatigue Impact Scale), health-related quality of life (SF-36), and disability status (EDSS score). The EDSS scores were determined again at least three years later. Univariate and multivariate analysis were performed to determine the predictive value of different dimensions of fatigue and other variables (depression and SF- 36) on the change in disability status. Of the 196 patients, 106 (54%) patients had an unchanged status or improvement and 90 (46%) showed a worsening of disability. After three years, with control for gender, age, and baseline disability status, a high baseline level of physical fatigue was associated with a worsening of disability status, whereas a low baseline level of physical fatigue was associated with the absence of worsening of the EDSS score. Other dimensions of fatigue, depression and SF-36 were not associated with a worsening of disability.A patient's perceived fatigue may be not only a clinically and psychosocially meaningful outcome but also a predictor of objective outcomes such as changes in disability status at three years.

Sleep disorders and fatigue in multiple sclerosis: Evidence for association and interaction

“…However, physical fatigue specifically appears to be related to physical impairment as measured by the expanded disability status scale (EDSS) [10,50]. Moreover, a high baseline level of physical fatigue correlated with worsening EDSS score after three years [51]. Increased pain severity has also been associated with greater fatigue in MS [10,41].…”

Measuring the Quality of Life in Patients with Multiple Sclerosis in Clinical Practice: A Necessary Challenge

“…Predictive factors of long-term disability in patients with MS were also previously reported [60, 61]: sociodemographic variables [62, 63], initial EDSS score or initial change in EDSS score [61, 64], number or types of relapses [61, 62], nature of the initial symptoms [65], and MRI findings [66]. The weight of these factors is poorly understood and does not explain the entire change of disability that is observed.…”

What is the relevance of quality of life assessment for patients with attention impairment?

“…ii) We did not consider factors previously associated to cognitive performance, such as depression [26], fatigue [27], and MS medications [28]. However, the aim of this study was to provide evidence supporting the conclusion that cognitively impaired MS patients reliably answer a self-reported QoL questionnaire regardless of the presence or absence of other factors that could have influenced their performance.…”