Predictors of Quality of Life in Multiple Sclerosis: Relationships between Cognitive, Physical, and Subjective Measures of Disease Burden

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Title: Predictors of Quality of Life in Multiple Sclerosis: Relationships between Cognitive, Physical, and Subjective Measures of Disease Burden
Author: Noll, Kyle Richard
Abstract: The varied constellation of symptoms characteristic of multiple sclerosis (MS ) are often functionally impairing , affecting the health -related quality of life (QoL ) of many of those afflicted . However , it remains unclear to what extent subjective , cognitive , and physical measures differentially predict overall health -related QoL in MS , and which (combination of ) factors are most useful when making clinical inferences regarding patient well -being . Stepwise linear regression analyses were used to investigate predictors of QoL in 55 consecutive MS patients , recruited as part of the Cognition and Demyelinating Disease project at the UTSW MS Clinic . Out of all cognitive , physical , and self -report predictors of overall health -related QoL , only the Modified Fatigue Impact Scale (MFIS ) was significant , accounting for 31 % of the variance in Overall scores on the MSQOL -54 (p < .001 ) . Significant predictors of mental health -related QoL included the Quick Inventory of Depressive Symptoms (QIDS ) and the Modified Fatigue Impact Scale (MFIS ) (p < .001 ) . The QIDS alone accounted for 64 % of the variance in MSQOL -54 Mental Composite scores , which increased to 71 % with the inclusion of the MFIS . Significant predictors of physical health -related QoL included the MFIS , Timed 25 -Foot Walk (T25FW ) , and Multiple Sclerosis Neuropsychological Questionnaire (MSNQ ) (p < .001 ) . The MFIS alone accounted for 72 % of the variance in MSQOL -54 Physical Composite scores , which increased to 76 % with the inclusion of the T25FW , and 78 % when the MSNQ was also added . These results suggested that measures of self -reported fatigue and depression were the best predictors of health -related QoL in the domains of overall , physical , and mental functioning . In light of these findings , screening for fatigue and mood dysregulation should be incorporated into routine clinical evaluations of MS patients . Results of ROC analyses revealed that the QIDS and MFIS were both significant discriminators of level of QoL (high vs . low ) for each of the three MSQOL -54 summary measures (AUCs = .79 to .92 ) . Examining rates of correct classification , specificity , and sensitivity , indicated that cut -scores of greater than nine on the QIDS and greater than 37 on the MFIS were optimal for discriminating between low and high QoL .
URI: http : / /hdl .handle .net /2152 .5 /951
Date: 2011-12-14

Citation

Predictors of Quality of Life in Multiple Sclerosis: Relationships between Cognitive, Physical, and Subjective Measures of Disease Burden. Graduate School of Biomedical Sciences. Available electronically from http : / /hdl .handle .net /2152 .5 /951 .

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