Predictors and moderators of the disablement process in persons with multiple sclerosis

The purpose of this study is to explore how selected behavioral and psychological factors may influence the disablement process in persons with multiple sclerosis. Specifically, we explored what contextual factors (age, length of diagnosis, comorbidities), resources (social support, adequacy of assistive devices), barriers, and health behaviors predict functional limitations, disability, and quality of life and what factors might moderate the relationship between functional limitation and disability and disability and quality of life. A sample of 442 persons with multiple sclerosis (371 females, 71 males; mean age 56, mean time since diagnosis 19 years) completed measures of demographic and disease-related variables, barriers, social support, health behaviors, functional limitations, disability and perceived quality of life. Using regression analyses, the predictors explained significant amounts of variance in functional limitations (R2 = 0.37), disability (R2 = 0.36) and quality of life (R2 = 0.68), but there were no significant moderators of the relationship between functional limitations and disability and disability and quality of life. A model testing the indirect effects of functional limitations and direct effects of disability and the proposed moderators explained 66% of the variance in quality of life (CFI = 0.95, TLI = 0.89, RMSEA = 0.10). Barriers, social support and health behaviors were consistent predictors of the outcome variables.