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Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan

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Abstract

Purpose

To describe symptom clusters based on severity of co-occurring symptoms among adults with multiple sclerosis (MS) by age groups and to further examine symptom clusters as a correlate of quality of life (QOL) by age groups.

Methods

This cross-sectional study enrolled persons with MS between 20 and 79 years of age who completed measures of fatigue, depression, anxiety, sleep quality, and QOL using the 36-Item Short Form Health Survey. Bivariate correlation and partial correlation analyses examined associations among symptoms, QOL, and MS characteristics. K-means cluster analyses determined symptom clusters among the full sample and pre-determined age groups (i.e., 20–39, 40–59, and 60–79). One-way ANOVAs examined differences in QOL among clusters for the overall sample and by age groups.

Results

Among the overall sample of 205 participants, symptoms were significantly correlated with QOL and three distinct clusters were identified and differentiated by the magnitude of symptom experience (i.e., mild, moderate, and severe). Results were consistent among young and middle-aged adults; however, among older adults two severe sleep problem clusters were identified that were distinguished by moderate versus severe fatigue, depression, and anxiety. ANOVAs among the overall sample indicated that the three symptom clusters varied significantly for both physical component scores, F(2, 202) = 12.03, p < .001, η2 = .10, and mental component scores, F(2, 202) = 137.92, p < .001, η2 = .58; severe symptom cluster was associated with worse QOL. Patterns in the age subgroup ANOVAs were consistent.

Conclusions

Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

N/A.

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Funding

Funding for this study was provided by the National Multiple Sclerosis Society [CA-1708-29059]. Research reported in this publication was supported, in part, by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [F32HD101214; F31HD097903] and the National Heart, Lung, and Blood Institute of the National Institutes of Health [T32HL105349]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA

    Stephanie L. Silveira, Katie L. J. Cederberg, Brenda Jeng, Brian M. Sandroff, Catherine D. Jones & Robert W. Motl

  2. Department of Occupational Therapy, Shenandoah University, Winchester, VA, USA

    E. Morghen Sikes

Authors
  1. Stephanie L. Silveira
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  2. Katie L. J. Cederberg
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  7. Robert W. Motl
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Contributions

RWM and BMS contributed to the study conception and design. All authors lead in material preparation and data collection. SLS lead data analyses with contributions from all authors. The first draft of the manuscript was written by SLS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Stephanie L. Silveira.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by University of Alabama at Birmingham Institutional Review Board and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Silveira, S.L., Cederberg, K.L.J., Jeng, B. et al. Symptom clusters and quality of life in persons with multiple sclerosis across the lifespan. Qual Life Res 30, 1061–1071 (2021). https://doi.org/10.1007/s11136-020-02689-x

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