The Relationship Of Anxiety, Depression, Resilience, And Sleep Quality With Fatigability Severity In Persons With Multiple Sclerosis

PURPOSE: Fatigability is commonly reported symptoms among persons with Multiple Sclerosis (PwMS), contributing to decline in activities of daily living. Yet, little is known concerning factors contribute to fatigability in PwMS. The study aims to investigate the role of anxiety, depression, resilience, and sleep quality on fatigability in PwMS. METHODS: 66 PwMS participated in this study. Fatigability severity measures were assessed following a standardized 10-minute walk test at self-selected pace. Perceived fatigability (PercF) was a ratio of participant perceived change in fatigue and total distance walked in meters. Performance fatigability (PerfF) was a ratio of the change in walking velocity (at 2.5 and 10 minutes) and total distance walked in meters. Participants also completed the Hospital Anxiety and Depression Scale (HADS), the Brief Resilience Scale (BRS), and the Pittsburgh Sleep Quality Index (PSQI). Pearson correlation coefficient was calculated to determine the relationship between study variables. Simple and Stepwise linear regression analyses were performed to explore the contributions of anxiety, depression, resilience, and sleep quality as predictors of PercF and PerfF. RESULTS: Results showed that PerfF/PercF correlated positively with HADS and PSQI scores and negatively with BRS score. Only HADS scores significantly correlated with PerfF (p ≤ 0.05), while HADS, PSQI and BRS scores significantly correlated with PercF (p ≤ 0.05). The simple regression analysis showed that only HADS-Anxiety score is significantly associated with PerfF (β = 0.248, 95% CI: 0.001 - 0.104, p = 0.045). The analysis also showed that HADS (Anxiety & Depression) scores are significantly associated with PercF (Anxiety: β = 0.246, 95% CI: 0.007- 0.864, p = 0.047; Depression: β = 0.303 ,95% CI: 0.120 - 0.992, p = 0.013). In the stepwise regression analysis, results for the final model showed that anxiety score is a significant predictor (p = 0.045) for PerfF, while depression score is a significant predictor for PercF (p = 0.013). CONCLUSION: Anxiety and depression are potential predictors of fatigability in our study sample. Developing a holistic approach that early and regularly assess psychological factors is crucial for effective fatigability management in PwMS and therefore positive health-related outcomes.