Quality of life in aging multiple sclerosis patients

Aliza Bitton Ben-Zacharia, Allison Squires

Research output: Contribution to journalArticle

Abstract

Objective. To evaluate the association between clinical and demographic factors and health-related quality of life (HRQOL) among older people with multiple sclerosis (MS). Design. Cross-sectional survey-based study. Setting and participants. Patients with MS aged 60 years or older were recruited from 4 MS centers in Long Island, NY. Patients with severe cognitive impairment as determined by the health care practitioner were excluded. Participants were asked to complete 3 surveys at 3 different time-points. In the first survey, participants completed the Morisky Medication Adherence Scale and the Patient Multiple Sclerosis Neuropsychological Screening Questionnaire (P-MSNQ). The second survey was the Multiple Sclerosis Quality of Life-54 (MSQOL-54), and the third survey included the Beck Depression Inventory-II (BDI-II) and a disability status self-assessment scale. Cognitive function was measured at the time of recruitment using the Symbol Digit Modalities Test (SDMT). Analysis. The Andersen Healthcare Utilization model was used to structure the multivariate regression analysis. This model identifies multiple domains affecting quality of life, and the variables from the surveys were categorized according to domain: predisposing characteristics (demographic variables), enabling resources (caregiver support and living situation), needs (eg, health-related measures), and health behaviors (medication use, adherence). Main results. A total of 211 completed the first survey, 188 the second, and 179 the third. 80% were female and 95% were white. Average age was 65.5 (SD 5.6) years. 56% of respondents' self-reported scores on the SDMT classified them as cognitively impaired. Risk of neuropsychological impairment, depression, and disability status were significantly associated with a decreased mental and physical HRQOL. Significantly, there was a strong association between predisposing characteristics and QOL. Being widowed and remaining employed were the strongest predictors of better physical QOL and having an education level of high school or less was a predictor of lower mental HRQOL. Conclusion. Clinicians should measure HRQOL in older MS patients regularly and assess for depression and cognitive impairment.

Original languageEnglish (US)
JournalJournal of Clinical Outcomes Management
Volume21
Issue number10
StatePublished - Oct 1 2014

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Multiple Sclerosis
Quality of Life
Medication Adherence
Depression
Mental Health
Demography
Delivery of Health Care
Widowhood
Surveys and Questionnaires
Health Behavior
Islands
Cognition
Caregivers
Multivariate Analysis
Cross-Sectional Studies
Regression Analysis
Education
Equipment and Supplies
Health

ASJC Scopus subject areas

  • Medicine(all)
  • Health Policy

Cite this

Quality of life in aging multiple sclerosis patients. / Bitton Ben-Zacharia, Aliza; Squires, Allison.

In: Journal of Clinical Outcomes Management, Vol. 21, No. 10, 01.10.2014.

Research output: Contribution to journalArticle

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abstract = "Objective. To evaluate the association between clinical and demographic factors and health-related quality of life (HRQOL) among older people with multiple sclerosis (MS). Design. Cross-sectional survey-based study. Setting and participants. Patients with MS aged 60 years or older were recruited from 4 MS centers in Long Island, NY. Patients with severe cognitive impairment as determined by the health care practitioner were excluded. Participants were asked to complete 3 surveys at 3 different time-points. In the first survey, participants completed the Morisky Medication Adherence Scale and the Patient Multiple Sclerosis Neuropsychological Screening Questionnaire (P-MSNQ). The second survey was the Multiple Sclerosis Quality of Life-54 (MSQOL-54), and the third survey included the Beck Depression Inventory-II (BDI-II) and a disability status self-assessment scale. Cognitive function was measured at the time of recruitment using the Symbol Digit Modalities Test (SDMT). Analysis. The Andersen Healthcare Utilization model was used to structure the multivariate regression analysis. This model identifies multiple domains affecting quality of life, and the variables from the surveys were categorized according to domain: predisposing characteristics (demographic variables), enabling resources (caregiver support and living situation), needs (eg, health-related measures), and health behaviors (medication use, adherence). Main results. A total of 211 completed the first survey, 188 the second, and 179 the third. 80{\%} were female and 95{\%} were white. Average age was 65.5 (SD 5.6) years. 56{\%} of respondents' self-reported scores on the SDMT classified them as cognitively impaired. Risk of neuropsychological impairment, depression, and disability status were significantly associated with a decreased mental and physical HRQOL. Significantly, there was a strong association between predisposing characteristics and QOL. Being widowed and remaining employed were the strongest predictors of better physical QOL and having an education level of high school or less was a predictor of lower mental HRQOL. Conclusion. Clinicians should measure HRQOL in older MS patients regularly and assess for depression and cognitive impairment.",
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