Depression, Fatigue, Declines in Cognitive Function, and Uncertainty on Quality of Life Outcomes in Women with Multiple Sclerosis

Background: MS, a chronic disease of the central nervous system, is a leading cause of neurological disability among young adults.  The most prevalent neurological disease among young and middle-aged adults, MS is typically diagnosed in men and women between the ages of 20 and 40.  While disease severity is not age dependent and the lifetime expectancy for this population remains normal, the healthcare costs associated with MS are estimated at over $10 billion annually.

Objectives: In a pilot dissertation study completed in 2014, the common symptoms of multiple sclerosis (MS) were evaluated to determine if a relationship exists between depression, fatigue, and declines in cognitive function. The researcher also evaluated whether depression, fatigue, declines in cognitive function, uncertainty, enabling skills and self-management influenced quality of life outcomes in women with MS.

Methods: Eight different measurement tools were utilized in conjunction with a modified theoretical framework involving over two hundred women located in the southwest United States.  Data analysis involved descriptive statistics, correlations and linear regression to answer the specific aims.

Results: The major findings for this study include significant relationships between: 1) depression and fatigue; 2) depression and declines in cognitive function; and 3) fatigue and declines in cognitive function.  Depression, fatigue, and declines in cognitive function were all significantly related to increased uncertainty.  Increased depression, fatigue and declines in cognitive function were also significantly associated with lower physical health and lower mental health as well as poorer quality of life outcomes in women with MS.  Finally, greater uncertainty was associated with lower physical health, lower mental health, and poorer quality of life.

Conclusions: The research findings suggest a symptom cluster exists with respect to depression, fatigue and declines in cognitive function.  An intervention aimed at developing an interdisciplinary approach to educate healthcare providers in evaluating for all three symptoms is recommended.  Additionally, individuals with MS could benefit from the development of a self-help intervention program. A research study including a larger population of women with MS located throughout the United States, and not just the southwest, is necessary before any education aimed at healthcare professionals or individuals with MS is developed or implemented.