Association between fatigue and functional status among patients with multiple sclerosis

Fatigue is one of the most common and disabling symptoms experienced by patients with multiple sclerosis (MS). This study aimed to assess the association between fatigue and functional status among patients with multiple sclerosis.

A descriptive correlational cross-sectional study was conducted in September 2025 to January 2026, on 78 patients diagnosed with MS using a purposive sampling method, at Nasser Institute Hospital, Egypt. Data were collected using a structured interview questionnaire, the Fatigue Severity Scale, Lawton and Brody's Instrumental Activities of Daily Living Scale (IADL), the MS Walking Scale, and the Social Functioning Questionnaire. Data were analyzed using SPSS version 25. Statistical significance was considered at p < 0.05.

After assessment using the Fatigue Severity Scale, 46.1% of participants were classified as having severe fatigue, 52.6% had moderate fatigue, and 1.3% had mild fatigue. Female participants reported higher fatigue scores than males. More than half of the participants demonstrated impaired social functioning, and a considerable proportion exhibited dependence in instrumental activities of daily living and moderate-to-severe walking impairment. Significant positive correlations were observed between fatigue severity and dependence in instrumental activities of daily living, walking impairment, and social dysfunction (all p < 0.001). In the multiple linear regression analysis, after adjusting for confounding variables, the overall model was statistically significant (R ² = 0.545, adjusted R ² = 0.500, F = 11.984, p < 0.001). Greater walking impairment (MSWS-12; β = 0.371, p = 0.010) and poorer instrumental activities of daily living (IADL; β = 0.311, p = 0.033) remained independently associated with higher fatigue severity, whereas social functioning was not independently associated with fatigue severity after adjustment (β = 0.200, p = 0.095).

Fatigue is highly prevalent among patients with MS and is significantly associated with poorer functional status, particularly reduced instrumental activities of daily living and greater walking impairment. Routine assessment of fatigue and the development of comprehensive fatigue-management strategies may help identify patients at risk of functional limitations and support the delivery of individualized care aimed at maintaining independence, mobility, and quality of life among individuals with MS.