The Interrelations Between Disability and Quality of Life in Patients with Multiple Sclerosis in the Area of Bajo Aragon, Spain: A Geographically Based Survey

Abstract

Multiple sclerosis (MS) is one of the most disabling diseases in young people, but the interrelation between disability and quality of life is poorly understood. As individual correlations between disability and the perspective of the patient may be weak in individual subjects, the purpose of our work was to analyze and correlate quality of life with neurologic impairment and disability in all patients with MS from the geographic area of the Bajo Aragón in the northeastern region of Spain. A total of 36 patients with a diagnosis of probable or clinically definite MS had an average age was 38.1 years (range,17-66 years). The majority of them were women (66.6%) and had relapsing-remitting forms (83.3%). The Minimal Record of Disability measured neurologic impairments, functional limitations, and handicaps. Quality of life was measured by the Functional Assessment of Multiple Sclerosis (FAMS) scale. Statistical analysis was performed with the Kruskal-Wallis nonparametric test and Pearson's coefficient of correlation. The mean EDSS of our cohort was 2.76 (range, 0-9). The mean FAMS score was 78.6 (SD, 52.5). We found that patients moderately or severely disabled (EDSS >3) showed a significantly decreased satisfaction in comparison with the nondisabled or mildly disabled ones. Disability and handicaps were significantly related to some items of FAMS: mobility, symptoms, and emotional well-being, but not with the remaining items: general contentment, thinking and fatigue, family and social well-being, and additional concerns. In comparison with patients from other population-based surveys, our patients were less disabled and enjoyed a better quality of life. Although we globally observed poorer quality of life in more disabled patients, the perspectives of the patients did not necessarily agree with disability scales in some domains of health. Quality of life should be included in the approach to MS patients if we want to provide cost-effective health care.

Quality of life in Polish patients with multiple sclerosis

“…This was previously also confirmed in other countries [13][14][15][16]. It has been shown that even in the early stage of disease, patients' QoL is significantly reduced [17].…”

“…Chronic and progressive diseases like MS seem to particularly modify an individual's QoL. This is confirmed by studies conducted in Sweden, Germany, Spain, the United States and Canada [13][14][15][16][17]. However, because of cultural and social differences and the organization of the health care system, the results of these studies cannot be directly linked to MS patients in Poland [18].…”

A review about the impact of multiple sclerosis on health-related quality of life

“…71 The original version of the FAMS is a very useful disease-targeted instrument to evaluate MS patients' HRQoL. 15,67,68 However, we feel that the modified FAMS offers a more holistic assessment of neurological symptoms and psychosocial complaints associated with MS in line with published recommendations regarding specific HRQoL instruments. 57,71 Hamburg Quality of Life Questionnaire in Multiple Sclerosis…”

Depression and multiple sclerosis: Review of a lethal combination

“…In their comparison of multiple QOL measures, Nicholl et al found that the FAMS was the most sensitive measure of the functional domains often associated with decreased QOL in MS patients [88]. In a study that assessed QOL among patients with MS in Spain, MS disability was related to emotional well-being (depression), mobility, and physical symptoms [89]. This study confirms that although depression is certainly a factor in adjustment to MS-related disability, other issues must also be considered and assessed.…”