Data from a pair of posters suggest that cognition, fatigue, and depression all impact social activity limitations in people with MS, rather than walking impairment alone.
Olivia Kaczmarek, BS
Data from a pair of poster presentations suggest that there is a strong need for further assessment of the limitations in social activity in individuals with multiple sclerosis (MS) due to the negative impacts stemming from invisible symptoms of the disease, such as cognition, fatigue, and depression.1,2
The first of the posters identified that severe impairment in walking ability, as measured by Patient Determined Disease Steps (PDDS), is not the sole contributing factor in limited social activities among these individuals. The findings showed that social roles and activities had a strong correlation with Hospital Anxiety and Depression Scale (HADS) and Modified Fatigue Impact Scale (MFIS) anxiety and depression scores. These scores, as well as Ability to Participate in Social Roles and Activities–Short Form (SRA) scores, all began to worsen by the time patients with MS identified as having “moderate” disability (but excluding walking ability limitations [PDDS group 2-3]).1
The second poster displayed data that indicate the need for further evaluations of cognition in those with MS as it relates to the ability to participate in social roles and activities. Cognition was deemed to impact SRA scores as they began to decline, and multiple individual cognitive domains were significantly related with SRA scores.2
Both posters were presented virtually at the Americas Committee for Treatment and Research in MS (ACTRIMS) Forum 2021, February 25-27, by Olivia Kaczmarek, BS, clinical research coordinator, South Shore Neurologic. “Disease burden and progression in people with [MS] is traditionally measured by reported relapse, [Expanded Disability Status Scale], and MRI change. Disease impact on…lifestyle and independence, including participation in social roles and activities has been associated with severe impairment in mobility, with EDSS scores of over 7, and are not typically assessed during routine care visits,” Kaczmarek and colleagues wrote.
“Analysis of depression, anxiety, and fatigue in relation to disease burden and disability and the impact on social role participation may provide novel insight and early detection for intervention,” they added.