Multidimensional Impairment in Multiple Sclerosis: Physical Disability, Cognitive Dysfunction, Sleep Disturbance, Fatigue, Depression, and Their Impact on Quality of Life—A Possible Common Pathological Pathway

QoL in MS reflects the combined burden of physical disability, cognitive impairment, fatigue, depression, and poor sleep quality, with phenotype-specific patterns. While physical disability is the main QoL determinant in progressive MS, cognitive deficits with slowed processing speed play an important role in relapsing MS. Comprehensive, multidimensional assessment, including sleep and mood screening, may support individualized management strategies in MS.