Symptom Clusters Correlated with QOL in MS

A study examined symptom clusters in adults with multiple sclerosis (MS) by age group and evaluated the relationship between symptom clusters and quality of life (QOL) by age group.

Patients with MS aged 20 to 79 years were eligible for inclusion. They reported fatigue, depression, anxiety, sleep quality, and QOL per the 36-Item Short Form Health Survey. Relationships between symptoms, QOL, and MS characteristics were examined through bivariate correlation and partial correlation analyses. K-means cluster analyses were used to establish symptom clusters in the overall study cohort as well as by age group: 20 to 39 years, 40 to 59 years, and 60 to 79 years. QOL differences among clusters in the overall cohort and the age groups were assessed using one-way analysis of variance (ANOVA).

The study population encompassed 205 patients. A significant correlation between symptoms and QOL was observed. Three clusters were identified and differentiated by mild, moderate, and severe symptom experience. Outcomes were similar between young and middle-aged adults, but two severe sleep problem clusters were observed in the older adult group, which were differentiated by moderate versus severe fatigue, depression, and anxiety.

Overall, ANOVAs suggested that there were significant variations among the three symptom clusters for physical component scores (F[2, 202]=12.03; P<0.001) and mental component scores (F[2, 202]=137.92; P<0.001). Severe symptom cluster was indicative of worse QOL. Patterns were similar among the age subgroup ANOVAs.

“Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed,” the study authors concluded.