Are There Modifiable Lifestyle Factors That Contribute to MS Fatigue?

A study evaluated modifiable lifestyle factors and patient- and disease-related characteristics in patients with multiple sclerosis (MS) that were correlated with fatigue.

The study was a secondary analysis of a pragmatic randomized, controlled trial of inpatient multidisciplinary rehabilitation in Denmark that included patients with MS aged 18 to 65 years who had an Expanded Disability Status Scale disease severity score ≤7.5. Baseline data collection included patient- and disease-related characteristics, fatigue impact (Modified Fatigue Impact Scale [MFIS]), and lifestyle factors (tobacco smoking, alcohol intake, and physical activity).

Final analysis included 417 patients with MS. The median age was 51 years, most patients were female (69%), and the median time since diagnosis was eight years; 41% of patients had relapsing-remitting MS.

Factors associated with higher MFIS total scores included shorter time since diagnosis, being a tobacco smoker, and not regularly taking part in physical activity. Results were similar for MFIS physical, cognitive, and psychosocial subscores, notably in physical scores.

Upon multivariate analyses, significant correlations were observed between physical activity and fatigue impact on total, physical, and psychosocial functioning; tobacco smoking was significantly correlated with fatigue impact on psychosocial functioning; and alcohol intake had no correlation with fatigue impact. No relationship was observed between any of the lifestyle factors and fatigue impact on cognitive functioning. In adjusted models, a significant correlation was observed between time since diagnosis and fatigue impact on total, physical, and cognitive functioning, as well as between disease severity and fatigue impact on physical and cognitive functioning.

“Introducing or supporting maintenance of physical activity/exercise and cessation of tobacco smoking seems to be a useful approach for rehabilitation services to help patients with MS manage fatigue,” the researchers wrote in their conclusion.