Self-reported symptoms in Multiple Sclerosis do not impact five-year adherence to healthy lifestyle

People living with multiple sclerosis (plwMS) face numerous symptoms that may progressively worsen and impact daily living activities. PlwMS adhering to healthy lifestyle, appear to have fewer MS symptoms, slowed disease progression, and better quality of life. However, MS symptoms may prevent long-term adherence to healthy lifestyle. For example, fatigue, depression, and disability are reported to limit physical activity. We assessed symptoms identified as most important to plwMS and whether these symptoms impacted their adherence to healthy lifestyle.

Data from 671 plwMS from the longitudinal HOLISM observational study were analysed. Of 22 queried symptoms, participants ranked the top three most important to them. Lifestyle factors assessed were high-quality diet, vitamin D supplementation, meditation, physical activity, and non-smoking. Associations between top symptoms and lifestyle were assessed using log-binomial regression adjusted for appropriate confounders.

Top three important symptoms were fatigue, mobility, and cognitive function. Cross-sectional associations were observed between fatigue and physical activity (aRR=0.73, 95 %CI=0.59-0.91) and ≥3 lifestyle factors (aRR=0.82, 95 %CI=0.67-0.99), mobility with vitamin D supplementation (aRR=1.29, 95 %CI=1.01-1.65) and physical activity (aRR=0.72, 95 %CI=0.55-0.94), and cognitive function with diet (aRR=0.75, 95 %CI=0.59-0.94). Prospective associations were found between mobility and physical activity (aRR=0.73, 95 %CI=0.54-0.99), and cognitive function with non-smoking (aRR=1.03, 95 %CI=1.00-1.06).

Fatigue, mobility, and cognitive function are important symptoms for plwMS. These symptoms generally are not barriers to healthy lifestyle, except for mobility for physical activity. Determining barriers and facilitators for long-term adherence to healthy lifestyle may inform efforts to support plwMS improve lifestyle engagement.