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Interaction of physical function, quality of life and depression in Amyotrophic lateral sclerosis: characterization of a large patient cohort.

Körner S, Kollewe K, Abdulla S, Zapf A, Dengler R, Petri S - BMC Neurol (2015)

Bottom Line: QoL of ALS patients was reduced in nearly all SF-36-categories.Regarding distinct patient characteristics one of the most interesting findings was that increasing age was correlated with significantly worse QoL results regarding social functioning.Being aware of these differences can be valuable for both ALS professional and family caregivers and physicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Koerner.Sonja@mh-hannover.de.

ABSTRACT

Background: Due to lack of any curative therapy for ALS, symptomatic treatment and maintenance of quality of life (QoL) is very important. We aimed to characterize the affected domains of QoL in ALS patients and to identify factors which are associated with reduced QoL and increased depression.

Methods: 159 ALS patients answered standardized questionnaires (Beck Depression Inventory-II, SF-36 Health Survey questionnaire, revised ALS functional rating scale). Multiple regression analysis was used to identify correlations between clinical features of ALS patients and depression/QoL scores. In addition, QoL data from ALS patients were compared to age-matched reference values representing the German normal population.

Results: QoL of ALS patients was reduced in nearly all SF-36-categories. Progression of physical impairment was positively correlated with depression but reduced QoL scores only in items directly related to physical function. However, QoL was considerably influenced by depression, independently from physical impairment. Regarding distinct patient characteristics one of the most interesting findings was that increasing age was correlated with significantly worse QoL results regarding social functioning.

Conclusions: Depressive symptoms had a strong influence on QoL, hence their detection and treatment is of particular importance. Different domains of QoL are differently affected in subgroups of ALS patients. Being aware of these differences can be valuable for both ALS professional and family caregivers and physicians.

No MeSH data available.


Related in: MedlinePlus

Linear regression analysis showed a significant negative correlation between ALSFRS-R and BDI. Advanced physical impairment (lower ALSFRS-R) was correlated with increasing depression (higher BDI scores)
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Fig2: Linear regression analysis showed a significant negative correlation between ALSFRS-R and BDI. Advanced physical impairment (lower ALSFRS-R) was correlated with increasing depression (higher BDI scores)

Mentions: Linear regression analysis was performed to identify impact factors on depression and QoL. The results of the final model after backward selection are displayed in Table 3. (All results including the results of the simple regression models are summarized in Additional file 1: Table S1). Advanced physical impairment (lower ALSFRS-R) was correlated with increasing depression (higher BDI scores) (Fig. 2). The multiple regression analysis showed that the extent of physical impairment also had an independent impact on the QoL (SF-36) scales related to physical functioning and vitality, regardless of the severity of depression, while the other six categories were not affected (Table 3). The level of depression, on the other hand, independent of the ALSFRS-R score, significantly influenced the majority of QoL categories, including general health, vitality, social functioning, emotional role and mental health (Table 3). That was also the case when we used the BDI score without somatic items, except for the QoL categories physical role and bodily pain (Additional file 2: Table S2).Fig. 2


Interaction of physical function, quality of life and depression in Amyotrophic lateral sclerosis: characterization of a large patient cohort.

Körner S, Kollewe K, Abdulla S, Zapf A, Dengler R, Petri S - BMC Neurol (2015)

Linear regression analysis showed a significant negative correlation between ALSFRS-R and BDI. Advanced physical impairment (lower ALSFRS-R) was correlated with increasing depression (higher BDI scores)
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4493831&req=5

Fig2: Linear regression analysis showed a significant negative correlation between ALSFRS-R and BDI. Advanced physical impairment (lower ALSFRS-R) was correlated with increasing depression (higher BDI scores)
Mentions: Linear regression analysis was performed to identify impact factors on depression and QoL. The results of the final model after backward selection are displayed in Table 3. (All results including the results of the simple regression models are summarized in Additional file 1: Table S1). Advanced physical impairment (lower ALSFRS-R) was correlated with increasing depression (higher BDI scores) (Fig. 2). The multiple regression analysis showed that the extent of physical impairment also had an independent impact on the QoL (SF-36) scales related to physical functioning and vitality, regardless of the severity of depression, while the other six categories were not affected (Table 3). The level of depression, on the other hand, independent of the ALSFRS-R score, significantly influenced the majority of QoL categories, including general health, vitality, social functioning, emotional role and mental health (Table 3). That was also the case when we used the BDI score without somatic items, except for the QoL categories physical role and bodily pain (Additional file 2: Table S2).Fig. 2

Bottom Line: QoL of ALS patients was reduced in nearly all SF-36-categories.Regarding distinct patient characteristics one of the most interesting findings was that increasing age was correlated with significantly worse QoL results regarding social functioning.Being aware of these differences can be valuable for both ALS professional and family caregivers and physicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Koerner.Sonja@mh-hannover.de.

ABSTRACT

Background: Due to lack of any curative therapy for ALS, symptomatic treatment and maintenance of quality of life (QoL) is very important. We aimed to characterize the affected domains of QoL in ALS patients and to identify factors which are associated with reduced QoL and increased depression.

Methods: 159 ALS patients answered standardized questionnaires (Beck Depression Inventory-II, SF-36 Health Survey questionnaire, revised ALS functional rating scale). Multiple regression analysis was used to identify correlations between clinical features of ALS patients and depression/QoL scores. In addition, QoL data from ALS patients were compared to age-matched reference values representing the German normal population.

Results: QoL of ALS patients was reduced in nearly all SF-36-categories. Progression of physical impairment was positively correlated with depression but reduced QoL scores only in items directly related to physical function. However, QoL was considerably influenced by depression, independently from physical impairment. Regarding distinct patient characteristics one of the most interesting findings was that increasing age was correlated with significantly worse QoL results regarding social functioning.

Conclusions: Depressive symptoms had a strong influence on QoL, hence their detection and treatment is of particular importance. Different domains of QoL are differently affected in subgroups of ALS patients. Being aware of these differences can be valuable for both ALS professional and family caregivers and physicians.

No MeSH data available.


Related in: MedlinePlus