Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL, 35209, USA.
Department of Occupational Therapy, Shenandoah University, Winchester, VA, USA.
Qual Life Res. 2021 Apr;30(4):1061-1071. doi: 10.1007/s11136-020-02689-x. Epub 2020 Nov 5.
To describe symptom clusters based on severity of co-occurring symptoms among adults with multiple sclerosis (MS) by age groups and to further examine symptom clusters as a correlate of quality of life (QOL) by age groups.
This cross-sectional study enrolled persons with MS between 20 and 79 years of age who completed measures of fatigue, depression, anxiety, sleep quality, and QOL using the 36-Item Short Form Health Survey. Bivariate correlation and partial correlation analyses examined associations among symptoms, QOL, and MS characteristics. K-means cluster analyses determined symptom clusters among the full sample and pre-determined age groups (i.e., 20-39, 40-59, and 60-79). One-way ANOVAs examined differences in QOL among clusters for the overall sample and by age groups.
Among the overall sample of 205 participants, symptoms were significantly correlated with QOL and three distinct clusters were identified and differentiated by the magnitude of symptom experience (i.e., mild, moderate, and severe). Results were consistent among young and middle-aged adults; however, among older adults two severe sleep problem clusters were identified that were distinguished by moderate versus severe fatigue, depression, and anxiety. ANOVAs among the overall sample indicated that the three symptom clusters varied significantly for both physical component scores, F(2, 202) = 12.03, p < .001, η = .10, and mental component scores, F(2, 202) = 137.92, p < .001, η = .58; severe symptom cluster was associated with worse QOL. Patterns in the age subgroup ANOVAs were consistent.
Given the strong association between severity of symptom clusters and QOL, approaches for targeting co-occurring symptoms are critically needed.
按年龄组描述多发性硬化症（MS）成人中同时出现的症状严重程度的症状群，并进一步按年龄组研究症状群与生活质量（QOL）的相关性。
这项横断面研究纳入了 20 至 79 岁之间的多发性硬化症患者，他们使用 36 项简短健康调查（SF-36）完成了疲劳、抑郁、焦虑、睡眠质量和生活质量的测量。使用双变量相关和偏相关分析研究了症状、生活质量和 MS 特征之间的关联。K 均值聚类分析确定了全样本和预先确定的年龄组（即 20-39、40-59 和 60-79 岁）之间的症状群。单因素方差分析检验了总体样本和按年龄组的 QOL 聚类之间的差异。
在 205 名参与者的总体样本中，症状与 QOL 显著相关，确定了三个不同的聚类，这些聚类根据症状体验的严重程度（即轻度、中度和重度）来区分。在年轻和中年成年人中结果是一致的；然而，在老年人中，确定了两个严重的睡眠问题聚类，这些聚类通过中度与重度疲劳、抑郁和焦虑来区分。在总体样本中的方差分析表明，三个症状聚类在生理成分评分上差异显著，F(2, 202)=12.03，p<.001，η=0.10，以及心理成分评分，F(2, 202)=137.92，p<.001，η=0.58；严重症状聚类与 QOL 较差相关。在年龄亚组方差分析中的模式是一致的。
鉴于症状群严重程度与 QOL 之间的强烈关联，迫切需要针对同时出现的症状的方法。
