Depression, fatigue and disability

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Petr75
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Depression, fatigue and disability

Post by Petr75 » Sat Oct 26, 2019 9:36 pm

2019 Jul 28
Neurologische, Gemeinschaftspraxis, Bonn, Germany
Depression, fatigue and disability are independently associated with quality of life in patients with multiple Sclerosis: Results of a cross-sectional study.
https://www.ncbi.nlm.nih.gov/pubmed/31437741

Abstract
BACKGROUND:
Quality of life (QoL) is significantly impaired in patients with Multiple Sclerosis (MS). As the expanded disability status scale (EDSS) inadequately reflects the impact of clinical symptoms on QoL, the present study aimed to identify factors associated with reduced QoL in MS patients.
DESIGN:
Single-center cross-sectional study in 260 MS patients.
METHODS:
QoL was assessed by the Multiple Sclerosis International QoL Questionnaire (MusiQoL), depression by the Center for Epidemiological Studies Depression Scale (CES-D scale), and fatigue by the Fatigue Scale for motor function and cognition (FSMC).
RESULTS:
79.6% patients were female and 21.4% male. The mean age was 44.5 ± 11.2 years and the median EDSS 3.0 (range 0.0-8.5). 35.8% had depression and 56.9% moderate to severe fatigue. The mean MusiQoL index score was 73.9 ± 11.3. Using linear regression, depression, fatigue, family status, physical activity, and occupation were associated with QoL. EDSS was only associated with QoL in patients with an EDSS 0.5.0.
CONCLUSIONS:
Depression, fatigue, family status, physical activity, and occupational status were closely associated with QoL in MS patients. Potential measures to improve QoL include assessment and treatment of depression, physical exercise, and maintaining patients employed in accordance with their physical and mental disabilities.

robbie
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Location: Northern Ontario, Canada

Re: Depression, fatigue and disability

Post by robbie » Thu Oct 31, 2019 2:57 pm

Wonder what the results would be if the median EDSS was 8.5? If you get depressed at 3 God help you
Had ms for 28 yrs,
8.5 EDSS
SPMS, 54 yrs old
Taking it day by day

robbie
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Posts: 1297
Joined: Thu Jan 27, 2005 3:00 pm
Location: Northern Ontario, Canada

Re: Depression, fatigue and disability

Post by robbie » Tue Nov 05, 2019 9:54 am

0 = Normal
1-1.5 = No disability, but some abnormal neurological signs
2-2.5 = Minimal disability
3-4.5 = Moderate disability, affecting daily activities, but you can still walk
5-8 = More severe disability, impairing your daily activities and requiring assistance with walking
8.5-9.5 = Very severe disability, restricting you to bed
10 = Death
It's important to recognize that a one-point change at the lower end of the scale reflects more subtle changes than at the upper end of the scale. For example, a one-point change between 2 and 3 is not as great a progression of disability as between 8 and 9.
Had ms for 28 yrs,
8.5 EDSS
SPMS, 54 yrs old
Taking it day by day

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Petr75
Family Elder
Posts: 964
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic

Re: Depression, fatigue and disability

Post by Petr75 » Tue Nov 05, 2019 11:03 am

robbie wrote:
Tue Nov 05, 2019 9:54 am
0 = Normal
1-1.5 = No disability, but some abnormal neurological signs
2-2.5 = Minimal disability
3-4.5 = Moderate disability, affecting daily activities, but you can still walk
5-8 = More severe disability, impairing your daily activities and requiring assistance with walking
8.5-9.5 = Very severe disability, restricting you to bed
10 = Death
It's important to recognize that a one-point change at the lower end of the scale reflects more subtle changes than at the upper end of the scale. For example, a one-point change between 2 and 3 is not as great a progression of disability as between 8 and 9.

2019 May
Department of Neurology, Harvard Medical School, Boston, MA, USA; Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston
Time between expanded disability status scale (EDSS) scores.
https://www.ncbi.nlm.nih.gov/pubmed/30763908

Abstract
BACKGROUND:
Although the expanded disability status scale (EDSS) is the most commonly used measure of disability for multiple sclerosis, measurement of disability accumulation is complex due to the unequal steps of the scale.
OBJECTIVE:
To estimate the time between EDSS scores in a large MS cohort from a single center and determine the impact of functional system scores on EDSS transitions.
METHODS:
31,394 clinical visits with EDSS scores from 2054 subjects in the CLIMB longitudinal cohort study were included in our analysis. The time to each EDSS score and the time between each EDSS score were calculated using the nonparametric maximum likelihood estimate for interval censored data. For each initial EDSS value, the association between functional status scores and subsequent EDSS value was assessed using a mixed effects linear regression model, and the association with time to EDSS increase was assessed using a Cox proportional hazards model.
RESULTS:
The median time until EDSS 2, 3, 4, 5 and 6 in all subjects were 4.8, 15.1, 28.2, 31.2, and 32.4 years, respectively. The time intervals showed that the disability accumulation intervals from EDSS 4 to 6 were much shorter than the accumulation intervals from EDSS 0 to 3 or from EDSS 6 to 8. For EDSS of 1 or 1.5, pyramidal, cerebellar, sensory, bowel-bladder and mental system scores were associated with higher subsequent EDSS values. For higher EDSS values, only pyramidal and bowel-bladder scores maintained the association.
CONCLUSIONS:
Time between specific EDSS levels varies considerably. Certain functional system scores have greater predictive power for future EDSS-related disability despite same present EDSS level. These findings will assist in adaptation of the EDSS as an outcome measure to assess MS-related disability in clinical trials.

-------------------------------------------------------------------------------------------------------------------------

http://is.muni.cz

robbie
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Re: Depression, fatigue and disability

Post by robbie » Wed Nov 06, 2019 10:29 am

So from 4 to 6 there's a slow down In disability causing activity as opposed to the early and later stages where it's more prominent. 4 to 6 is a pivotal point good there's a lull there ,give you time to catch you breath and make some hard decisions for the future.
Had ms for 28 yrs,
8.5 EDSS
SPMS, 54 yrs old
Taking it day by day

User avatar
Petr75
Family Elder
Posts: 964
Joined: Sat Oct 19, 2013 10:17 am
Location: Czech Republic

Re: Depression, fatigue and disability

Post by Petr75 » Wed Aug 26, 2020 11:44 pm

2020 Aug 4
Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York
Diagnosis of depression in multiple sclerosis is predicted by frontal-parietal white matter tract disruption
https://pubmed.ncbi.nlm.nih.gov/32754832/

Abstract

Background: Persons with multiple sclerosis (PwMS) are at an elevated risk of depression. Decreased Conscientiousness may affect patient outcomes in PwMS. Low Conscientiousness has a strong correlation with depression. Previous work has also reported that white matter (WM) tract disruption in frontal-parietal networks explains reduced Conscientiousness in PwMS.

Objective: We hypothesized that Conscientiousness-associated WM tract disruption predicts new-onset depression over 5 years in PwMS and evaluated this by assessing the predictive power of mean Conscientiousness associated frontal-parietal network (CFPN) disruption in PwMS for clinically diagnosed depression over 5 years.

Methods: This longitudinal retrospective analysis included 53 PwMS who were not previously diagnosed as depressed. All participants underwent structural MRI. Medical records were reviewed to evaluate diagnosis of depression for these patients over 5 years. WM tract damage between pairs of gray matter regions in the CFPN was measured using diffusion imaging. The relationship between CFPN disruption and depression was analyzed using logistic regression.

Results: Participants with MS had a mean age of 46.0 years (SD = 11.2). 22.6% (n = 12) acquired a diagnosis of clinical depression over the 5-year period. Baseline disruption in the CFPN was a significant predictor (ROC AUC = 61.8%). of new-onset clinical depression, accounting for age, sex, lateral ventricular volume, disease modifying treatment, and lesion volume.

Conclusion: Baseline CFPN disruption is associated with progression to clinical depression over 5 years in PwMS. Development of new WM pathology within this network may be a risk factor for depression.

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