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. 2021 Mar 18;7(1):2055217321999826.
doi: 10.1177/2055217321999826. eCollection 2021 Jan-Mar.

High prevalence of fatigue in contemporary patients with multiple sclerosis

Line Broch  1   2   3 , Cecilia Smith Simonsen  1   2   3 , Heidi Øyen Flemmen  4   5 , Pål Berg-Hansen  2 , Åshild Skardhamar  2 , Heidi Ormstad  6 , Elisabeth Gulowsen Celius  2   3
Affiliations

High prevalence of fatigue in contemporary patients with multiple sclerosis

Line Broch et al. Mult Scler J Exp Transl Clin. .

Abstract

Objective: The prevalence of multiple sclerosis (MS)-related fatigue may have changed due to new diagnostic criteria and new disease modifying drugs. We aimed to assess the prevalence of fatigue in a contemporary MS cohort, and to explore associations between fatigue and clinical and demographic factors.

Methods: This is a cross-sectional study of the MS population in three Norwegian counties. Fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions (FSMC). We also assessed self-reported anxiety, depression and daytime sleepiness.

Results: The response rate was 64% (1599/2512). The mean age of the participants was 52 ± 13 years, median EDSS was 2.5 (IQR 1.5-3.0) and median disease duration from onset was 16 years (IQR 8-25). We found a prevalence of fatigue of 81%. Women had a higher prevalence of fatigue than men (83% vs 78%, p = 0.02). The prevalence increased with age (p < 0.001) and with increasing disease severity (p < 0.001), but in multivariate analyses, only sex and disease severity remained independent determinants of fatigue. Anxiety, depression, and daytime sleepiness were more prevalent in patients with fatigue than in those without fatigue (all p-values < 0.001).

Conclusion: The prevalence of fatigue is high in contemporary patients with MS. Fatigue is associated with female sex and level of disability, as well as with anxiety, depression and excessive daytime sleepiness.

Keywords: Multiple sclerosis; cohort study; fatigue; prevalence.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Patient selection. Legend: Flow chart depicting patient selection
Figure 2.
Figure 2.
Motor and cognitive fatigue by age. Legend: The prevalence of motor fatigue (blue graph) and cognitive fatigue (red graph) stratified by age.
Figure 3.
Figure 3.
Fatigue severity by age. Legend: The severity of fatigue stratified by patient age. The prevalence of severe fatigue peaked in patients aged 50–59.
Figure 4.
Figure 4.
Fatigue in relapsing vs progressive multiple sclerosis. Legend: Bar chart depicting the severity of fatigue in relapsing versus progressive multiple sclerosis
Figure 5.
Figure 5.
Fatigue stratified by neurologic disability. Legend: The prevalence of fatigue stratified by neurologic disability quantified by the Expanded Disability Status Scale (EDSS)
Figure 6.
Figure 6.
Fatigue severity in relation to anxiety, depression and excessive daytime sleepiness. Legend: The prevalence of anxiety, depression and excessive daytime sleepiness in patients related to the level of fatigue severity
See this image and copyright information in PMC

References

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