Eur J Neurol. 2021 Jun 3. doi: 10.1111/ene.14956. Online ahead of print.
ABSTRACT
BACKGROUND: Several modifiable lifestyle factors have been associated with the onset and health outcomes of multiple sclerosis (MS), including clinically significant fatigue. A combined lifestyle score approach represents one method of assessing their relationship with clinical outcomes.
OBJECTIVES: To examine the association of two lifestyle scores with clinically significant fatigue and change thereof over 2.5 years’ follow-up using inverse probability treatment weighting (IPTW).
METHODS: We used data on sociodemographic, lifestyle and clinical characteristics surveyed from an international cohort of people with MS at baseline and 2.5-year follow-up. Fatigue was defined by Fatigue Severity Scale (FSS>5), healthy lifestyle by the Healthy Lifestyle Index Score (HLIS) and the Smoking, Nutrition, Alcohol, Physical Activity (SNAP) score. Analyses were by IPTW accounting for age, sex, MS type, disability, treated comorbidity number, immunomodulatory medication use, prescription antifatigue medication use, and ongoing relapse symptoms.
RESULTS: 1,268 participants completed the FSS at both timepoints, approximately 62% had fatigue. Using doubly robust IPTW, high (>11/20) HLIS (OR=0.90, 95% CI: 0.81-0.98) and high (>3/5) SNAP (OR=0.82, 95% CI: 0.73-0.90) were each associated with lower risk of fatigue at follow-up. Evaluating change in fatigue, higher SNAP score was associated with lower risk of fatigue (OR=0.89, 95% CI: 0.80-0.97) but that for HLIS did not reach statistical significance (OR=0.93, 95% CI: 0.85-1.01).
CONCLUSION: These results suggest a robust role for key lifestyle factors in preventing clinically significant fatigue and may represent a place for lifestyle modification in improving clinical outcomes in MS.
PMID:34081818 | DOI:10.1111/ene.14956
