title: Health-related quality of life in patients with longstanding 'benign multiple sclerosis'.
abstract: BACKGROUND
  We explored health-related quality of life (HRQoL) and psychosocial aspects in a cohort of patients with a history of longstanding benign MS (BMS).
  
  
  METHODS
  Patients with BMS (EDSS≤3 after 20 years disease duration) were re-assessed 25-30 years post-MS symptom onset for: EDSS, HRQoL (MSQoL-54), depression (Beck Depression Inventory-II), and fatigue (Modified Fatigue Impact Scale). Associations between these measures and patient characteristics (age, disease duration, 'benign status' [remained benign (EDSS≤3) vs no longer benign (EDSS>3)]) were examined.
  
  
  RESULTS
  Of the 61 patients included, 36 (49%) remained benign and 25 (41%) progressed (EDSS>3). Overall, physical and mental HRQoL scores were positively associated with each other (r=0.63; p<0.0001) and both negatively correlated with fatigue (r=-0.76 and -0.44, respectively; p<0.0005) and depression (r=-0.55 and -0.77; p<0.0001). Patients who remained benign reported better physical HRQoL vs those no longer benign (mean (SD)=67.3±18.1 vs 50.7±19.9, p=0.001), but not mental health (mean (SD)=67.4±19.3 vs 65.0±20.6, p=0.639). Generally, neither age nor disease duration was strongly associated with HRQoL (r<0.35).
  
  
  CONCLUSIONS
  Lower self-reported physical or mental HRQoL was associated with worsening fatigue and depression. However, EDSS progression was associated with the physical, but not mental aspects of HRQoL. Patient-reported HRQoL in 'benign MS' provides insight on the impact of MS beyond EDSS alone.
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Anna-Marie
authors: AM
authors: Bueno
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Ana-Luiza
authors: AL
authors: Sayao
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Masoud
authors: M
authors: Yousefi
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Virginia
authors: V
authors: Devonshire
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, Canada; Brain Research Centre, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
authors: Anthony
authors: A
authors: Traboulsee
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Vancouver, Canada; Brain Research Centre, Faculty of Medicine, University of British Columbia, Vancouver, Canada. Electronic address: helen.tremlett@ubc.ca.
authors: Helen
authors: H
authors: Tremlett
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003863:Depression / Q000209:etiology*; D004185:Disability Evaluation; D018450:Disease Progression; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index
keywords: Benign; Depression; Fatigue; Multiple sclerosis; Quality of life