A 10-year follow-up of a population-based study of people with multiple sclerosis in Stockholm, Sweden: changes in health-related quality of life and the value of different factors in predicting health-related quality of life.
BACKGROUND
Health-related quality of life (HRQL) in people with multiple sclerosis (PwMS) is negatively affected compared to that of the general population. Cognitive impairment and depressive symptoms have been shown to predict worse HRQL in a short-term perspective. Considering the progressive nature of MS, it is essential to include the long-term (10 years) perspective of HRQL in PwMS.


OBJECTIVE
The aim of this 10-year follow-up of a population-based sample of PwMS was to explore changes in and the predictive value of personal factors, degree of MS disability, depressive symptoms and cognitive impairment on HRQL.


METHODS
Data on personal and disease-specific factors, mood, and cognitive function was collected. Data on HRQL was collected, seen as a health profile with the Sickness Impact Profile, as a health index with the EuroQol 5D and as a single global question with the EQ Visual Analog Scale.


RESULTS
HRQL worsened over 10 years according to the health profile (Sickness Impact Profile Total and its physical dimension) and according to the health index. The effect sizes were small. HRQL assessed with the single global question remained unchanged. Depressive symptoms and cognitive impairment predicted worse HRQL.


CONCLUSIONS
In a 10-year perspective the HRQL with regard to its physical domain or when seen as a total health profile tends to get worse in PwMS. Yet, HRQL with regard to its psychosocial domain and with regard to PwMS' self-rated health, remains stable. There is a potential for health-care professionals to decrease the impact of modifiable factors on HRQL in PwMS by identifying those with depressive symptoms and/or cognitive impairment and initiating evidence-based treatment as well as meeting the need for environmental facilitators aiming at reducing disability.
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Karolinska University Hospital, Department of Physical Therapy, Stockholm, Sweden. Electronic address: charlotte.chruzander@ki.se.
Charlotte
C
Chruzander
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Karolinska University Hospital, Department of Physical Therapy, Stockholm, Sweden.
Charlotte
C
Ytterberg
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.
Kristina
K
Gottberg
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Karolinska University Hospital, Department of Physical Therapy, Stockholm, Sweden.
Ulrika
U
Einarsson
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Karolinska University Hospital, Department of Physical Therapy, Stockholm, Sweden.
Lotta
L
Widén Holmqvist
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Karolinska University Hospital, Department of Physical Therapy, Stockholm, Sweden.
Sverker
S
Johansson
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D011159:Population Surveillance / Q000379:methods*; D011237:Predictive Value of Tests; D011788:Quality of Life / Q000523:psychology; D013548:Sweden / Q000453:epidemiology
Health-related quality of life; Longitudinal; Multiple sclerosis; Population-based; Prognostic factors; Quality of life