Aprille Gangi, HS
,
Trinity College, Hartford, CT
Frederick W Foley, Ph.D.
,
Holy Name Medical Center, Teaneck, NJ, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
Jennifer A Ruiz, DPT
,
Departments of Rehabilitative Medicine and Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT
Heather M DelMastro, MS
,
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
Lindsay O Neto, MPH
,
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
Zaenab Dhari, MD
,
Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT
Albert C. Lo, MD, PhD
,
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT
Aaron P Turner, Ph.D. ABPP (RP)
,
Department of Rehabilitation Medicine, University of Washington, Seattle, WA, Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA, Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA
Thomas P Agresta, MD, MBI
,
Department of Family Medicine, University of Connecticut Health Center, Farmington, CT, Center for Quantitative Medicine, University of Connecticut Health Center, Farmington, CT
Elizabeth S Gromisch, PhD, MSCS
,
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, Departments of Rehabilitative Medicine and Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT
Background: Engagement in positive health behaviors (e.g., regular physical activity and healthy diet) are important factors for wellness with multiple sclerosis (MS). Although there is evidence of an association between these behaviors and high resilience in older adults with MS, this relationship has yet to be evaluated with younger adults. Furthermore, there has yet to be an exploration between resilience and objective health status metrics (e.g., body mass index (BMI)) and it is unclear whether having higher levels of resilience can moderate the relationship between health behaviors and MS symptoms.
Objectives: This study aimed to examine whether self-reported health behaviors and objective metrics differ between adults with MS (ages 22 to 74) with high and low resilience. Exploratory moderation analyses evaluated whether resilience affects the strength of the relationship between lifestyle and MS symptoms.
Methods: Participants were categorized as having either high resilience (n=28) or low resilience (n=31). The Simple Lifestyle Indicator Questionnaire (physical activity, diet, stress, and tobacco use) and AUDIT-C (alcohol consumption) were used to measure self-reported health behaviors, while BMI and blood pressure were extracted from the medical record. The SymptoMScreen was used to assess 12 common MS symptoms, with a composite score calculated. Regressions were conducted to examine the relationship between resilience and health behaviors, controlling for age, gender, disability, disease duration, and MS subtype. If significant, moderation analyses were then conducted.
Results: Persons with low resilience had lower levels of physical activity (b=3.30, p=.033) and greater life stress (Wald χ2(1)=10.93, p=.001) than persons with high resilience. While diet and BMI were associated with resilience in the bivariate analyses, they were no longer significant after considering the covariates. When resilience was low, there was a significant positive relationship between stress levels and MS symptoms (b = 4.68, p = .008). There was no evidence of resilience moderating the relationship between physical activity and MS symptoms (b = -0.62, p = .377).
Conclusions: Consistent with previous findings, resilience was positively associated with physical activity and negatively associated with life stress. Unlike in older adults, diet was not significantly different by resilience level. As the negative impact of stress on MS symptoms is greater in persons with low resilience, future research may explore psychosocial interventional approaches.
