Self-reported quality of life related to cognitive function and fatigue in adults with multiple sclerosis

Cognitive dysfunction and fatigue are two common chronic symptoms associated with multiple sclerosis (MS) and have significant impacts on quality of life (QoL). Assessment for potentially modifiable factors associated with these symptoms is needed to improve outcomes and QoL.

An electronic survey was developed and distributed to adults with MS, assessing demographics, MS disease factors, socioeconomic status, and QoL related to cognitive function and fatigue using Neuro-QoL^TM (Quality of Life in Neurological Disorders) measures. Multivariable linear regression models were developed to determine the contribution of these factors to Neuro-QoL T-scores.

332 participants completed the survey, with a mean age of 52 years. They were predominantly female (80 %) and White (85 %). The mean years since MS diagnosis was 15.6 years, with 81 % starting disease-modifying therapy (DMT) within 1 year of diagnosis. In a fit reduced model, higher QoL related to cognitive function was associated with starting a DMT and completion of Bachelor's degree, while lower QoL was related to self-reported diagnosis of depression and ≥ 2 flares since DMT initiation. For fatigue, higher QoL was associated with greater duration of MS and completion of a Bachelor's degree, and lower QoL with depression, ≥ 2 flares since DMT initiation, and higher self-reported disability.

In this survey of adults with MS, quality of life related to cognitive function was higher in those starting any efficacy of DMT. Larger longitudinal clinical studies should evaluate the impact of modifiable clinical factors on quality of life related to cognitive function and fatigue.