Highlights
- •Fatigue was strongly associated with fluctuations in MS impact on physical and psychological function, walking ability, and depression in MS.
- •Fatigue was associated with fluctuations in anxiety and perceived health, but to a lesser extent.
- •The interference of fatigue with responsibilities, work and social/family life and the physical effects of fatigue are most strongly related to fluctuations in MS outcomes.
Abstract
Background
Fatigue is a highly prevalent and disabling symptom of multiple sclerosis (MS). The
aetiology remains unclear, potentially resulting from neuroinflammatory or neurodegenerative
processes, mood disturbance, MS symptoms including pain, poor sleep, physical decompensation
or medication side effects. Cross-sectional associations have been reported between
fatigue and markers of physical and psychological health in people with MS. The current
study examined if fluctuations in markers of physical and psychological wellbeing
were associated with between-person differences in fatigue in MS.
Methods
Longitudinal data of up to 7 years was available of 3369 people with MS who were enrolled
in the UK MS Register. Participants completed MS impact scale ratings and MS walking
scales up to 4 times per year for up to 7 years. Fatigue was assessed at one time
point using the Fatigue Severity Scale. Multilevel analyses were conducted to examine
the degree of variance in the outcome measures accounted for by fatigue.
Results
Fatigue was associated with fluctuations in depression, MS impact, and walking ability,
and to a lesser extent with fluctuations in anxiety and perceived health status. Interference
of fatigue in participation in social activities and work-related responsibilities
and the physical effects of fatigue were most strongly related to MS-related outcomes.
Conclusion
Given the strong associations between fatigue and many MS outcomes, fatigue management
interventions are likely to impact on different aspects of physical and psychological
wellbeing in MS.
Keywords
Abbreviations:
FSS (Fatigue Severity Scale), HADS (Hospital Anxiety and Depression Scale), MS (Multiple sclerosis), MSIS-29 (MS Impact Scale-29), MSWS (MS walking scale), RRMS (relapsing remitting MS), PPMS (primary progressive MS), SPMS (secondary progressive MS)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 24, 2020
Accepted:
October 23,
2020
Received in revised form:
August 22,
2020
Received:
June 18,
2020
Identification
Copyright
© 2020 Published by Elsevier B.V.
