Associations between Lifestyle Behaviors and Quality of Life Differ Based on Multiple Sclerosis Phenotype.

Nupur Nag,Maggie Yu,Hollie Schmidt,Sandra Neate,George Jelinek,Steve Simpson-Yap

doi:10.3390/jpm11111218

Abstract

Multiple sclerosis (MS), a neuroinflammatory disorder, occurs as non-progressive or progressive phenotypes; both forms present with diverse symptoms that may reduce quality of life (QoL). Adherence to healthy lifestyle behaviors has been associated with higher QoL in people with MS; whether these associations differ based on MS phenotype is unknown. Cross-sectional self-reported observational data from 1108 iConquerMS participants were analysed. Associations between lifestyle behaviors and QoL were assessed by linear regression, and phenotype differences via moderation analyses. Diet, wellness, and physical activity, but not vitamin D or omega-3 supplement use, were associated with QoL. Specifically, certain diet types were negatively associated with QoL in relapsing-remitting MS (RRMS), and positively associated in progressive MS (ProgMS). Participation in wellness activities had mixed associations with QoL in RRMS but was not associated in ProgMS. Physical activity was positively associated with QoL in RRMS and ProgMS. Phenotype differences were observed in diet and wellness with physical QoL, and physical activity with most QoL subdomains. Our findings show lifestyle behaviors are associated with QoL and appear to differ based on MS phenotype. Future studies assessing timing, duration, and adherence of adopting lifestyle behaviors may better inform their role in MS management.

Highlights

Multiple sclerosis (MS), a chronic neuroinflammatory disorder, is commonly diagnosed in adults, predominantly women, aged 20 to 30 years [1]
For lifestyle behaviors, compared to relapsing-remitting MS (RRMS), people with progressive MS (ProgMS) were less likely to have used an anti-inflammatory diet, and less likely to be at an active level of physical activity
To inform potential lifestyle management strategies based on disease course, we assessed associations between diet, vitamin D and omega 3 supplementation, and participation in wellness and physical activities on quality of life (QoL) in people with MS (pwMS), and whether these associations differed in nature and magnitude between MS phenotypes

Summary

Introduction

Multiple sclerosis (MS), a chronic neuroinflammatory disorder, is commonly diagnosed in adults, predominantly women, aged 20 to 30 years [1]. 85% of people with MS (pwMS) are diagnosed with relapsing-remitting MS (RRMS) presenting with acute attacks of new or increasing neurologic symptoms, and 10–15% with primary progressive MS (PPMS) defined by deterioration of symptoms from onset without obvious relapses or remission [2]. 50–75% of RRMS cases convert to secondary progressive MS (SPMS) defined by gradual worsening of neurologic function alongside a general cessation of relapses [3]. Both RRMS and progressive MS (ProgMS) may manifest an array of physiological, psychological, and motor symptoms; the number and severity of these symptoms and associated impairment play a critical role in quality of life (QoL). Improvement of symptoms through adoption of healthy lifestyle behaviors has potential to improve QoL

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