Functional Decline is Associated with Hopelessness in Amyotrophic Lateral Sclerosis (ALS)

To determine the relationships between hopelessness, depression, quality of life, and disease progression in ALS.

Hopelessness and depression were assessed prospectively in a cohort of people with ALS using the Beck Hopelessness scale (BHS) and the ALS Depression Inventory (ADI-12), respectively. ALS Specific Quality of Life and measures of functional status (ALSFRS-R and forced vital capacity) were collected. Associations between changes in psychological health and functional scores were calculated using Spearman correlation coefficients.

Twenty-five people with ALS had at least 2 visits and were followed for a mean of 11 (± 6) months. People with hopelessness and depression reported worse quality of life (p<0.01 for both associations). Decline in function between any two visits measured by ALSFRS-R (p<0.01) and FVC (p=0.02) correlated with increased hopelessness, but not depression.

This study highlights the importance of monitoring hopelessness in ALS, particularly in patients with faster functional decline.