51
|
Can meditation influence quality of life, depression, and disease outcome in multiple sclerosis? Findings from a large international web-based study. Behav Neurol 2014; 2014:916519. [PMID: 25477709 PMCID: PMC4244947 DOI: 10.1155/2014/916519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 09/09/2014] [Accepted: 10/14/2014] [Indexed: 11/24/2022] Open
Abstract
Objectives. To explore the association between meditation and health related quality of life (HRQOL), depression, fatigue, disability level, relapse rates, and disease activity in a large international sample of people with multiple sclerosis (MS). Methods. Participants were invited to take part in an online survey and answer questions relating to HRQOL, depression, fatigue, disability, relapse rates, and their involvement in meditation practices. Results. Statistically and potentially clinically significant differences between those who meditated once a week or more and participants who never meditated were present for mean mental health composite (MHC) scores, cognitive function scale, and health perception scale. The MHC results remained statistically significant on multivariate regression modelling when covariates were accounted for. Physical health composite (PHC) scores were higher in those that meditated; however, the differences were probably not clinically significant. Among those who meditated, fewer screened positive for depression, but there was no relationship with fatigue or relapse rate. Those with worsened disability levels were more likely to meditate. Discussion. The study reveals a significant association between meditation, lower risk of depression, and improved HRQOL in people with MS.
Collapse
|
52
|
Abstract
Depression--be it a formal diagnosis based on consensus clinical criteria, or a collection of symptoms revealed by a self-report rating scale--is common in patients with multiple sclerosis (MS) and adds substantially to the morbidity and mortality associated with this disease. This Review discusses the prevalence and epidemiology of depression in patients with MS, before covering aetiological factors, including genetics, brain pathology, immunological changes, dysregulation of the hypothalamic-pituitary-adrenal axis, and psychosocial influences. Treatment options such as antidepressant drugs, cognitive-behavioural therapy, mindfulness-based therapy, exercise and electroconvulsive therapy are also reviewed in the context of MS-related depression. Frequent comorbid conditions, namely pain, fatigue, anxiety, cognitive dysfunction and alcohol use, are also summarized. The article then explores three key challenges facing researchers and clinicians: what is the optimal way to define depression in the context of diseases such as MS, in which the psychiatric and neurological symptoms overlap; how can current knowledge about the biological and psychological underpinnings of MS-related depression be used to boost the validity of this construct; and can intervention be made more effective through use of combination therapies with additive or synergistic effects, which might exceed the modest benefits derived from their individual components?
Collapse
|
53
|
Ploughman M, Beaulieu S, Harris C, Hogan S, Manning OJ, Alderdice PW, Fisk JD, Sadovnick AD, O'Connor P, Morrow SA, Metz LM, Smyth P, Mayo N, Marrie RA, Knox KB, Stefanelli M, Godwin M. The Canadian survey of health, lifestyle and ageing with multiple sclerosis: methodology and initial results. BMJ Open 2014; 4:e005718. [PMID: 25011993 PMCID: PMC4120418 DOI: 10.1136/bmjopen-2014-005718] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE People with multiple sclerosis (MS) are living longer so strategies to enhance long-term health are garnering more interest. We aimed to create a profile of ageing with MS in Canada by recruiting 1250 (5% of the Canadian population above 55 years with MS) participants and focusing data collection on health and lifestyle factors, disability, participation and quality of life to determine factors associated with healthy ageing. DESIGN National multicentre postal survey. SETTING Recruitment from Canadian MS clinics, MS Society of Canada chapters and newspaper advertisements. PARTICIPANTS People aged 55 years or older with MS symptoms more than 20 years. OUTCOME MEASURES Validated outcome measures and custom-designed questions examining MS disease characteristics, living situation, disability, comorbid conditions, fatigue, health behaviours, mental health, social support, impact of MS and others. RESULTS Of the 921 surveys, 743 were returned (80.7% response rate). Participants (mean age 64.6±6.2 years) reported living with MS symptoms for an average of 32.9±9.5 years and 28.6% were either wheelchair users or bedridden. There was only 5.4% missing data and 709 respondents provided optional qualitative information. According to data derived from the 2012 Canadian Community Health Survey of Canadians above 55 years of age, older people with MS from this survey sample are about eight times less likely to be employed full-time. Older people with MS were less likely to engage in regular physical activity (26.7%) compared with typical older Canadians (45.2%). However, they were more likely to abstain from alcohol and smoking. CONCLUSIONS Despite barriers to participation, we were able to recruit and gather detailed responses (with good data quality) from a large proportion of older Canadians with MS. The data suggest that this sample of older people with MS is less likely to be employed, are less active and more disabled than other older Canadians.
Collapse
Affiliation(s)
- Michelle Ploughman
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Serge Beaulieu
- Eastern Health Authority, St. John's, Newfoundland, Canada
| | - Chelsea Harris
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Stephen Hogan
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Olivia J Manning
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Penelope W Alderdice
- Recovery and Performance Laboratory, Rehabilitation Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - John D Fisk
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - A Dessa Sadovnick
- Department of Medical Genetics and Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul O'Connor
- Department of Neurology, St. Michaels Regional Hospital, Toronto, Ontario, Canada
| | | | - Luanne M Metz
- Department of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Penelope Smyth
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Nancy Mayo
- Department of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katherine B Knox
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mark Stefanelli
- Department of Neurology, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Marshall Godwin
- Primary Health Care Research Unit, Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| |
Collapse
|
54
|
Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. The association of diet with quality of life, disability, and relapse rate in an international sample of people with multiple sclerosis. Nutr Neurosci 2014; 18:125-36. [PMID: 24628020 PMCID: PMC4485697 DOI: 10.1179/1476830514y.0000000117] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objectives To explore the association between dietary factors including fat, fruit and vegetable intake, dairy and meat consumption, and health-related quality of life (HRQOL), disability and relapse rate in a large international sample of people with multiple sclerosis (MS). Methods Participants with MS were recruited to the study via Web 2.0 platforms and completed a comprehensive survey measuring demographic and clinical characteristics, HRQOL, disability, relapse rate, and the Diet Habits Questionnaire (DHQ). Results Of 2469 participants with confirmed MS, 2087 (84.5%) provided complete data on their dietary habits (DHQ total score). Multivariate regression models demonstrated that every 10-point increase on the DHQ total score was associated with nearly a six-point and five-point increase in physical and mental HRQOL, respectively, and 30.0% reduced likelihood of a higher level of disability. After controlling for age and gender, and the other dietary covariates, ‘healthy’ consumption of fruit and vegetables and dietary fat predicted better quality of life and less likelihood of higher disability when compared to respondents with a ‘poor’ diet. For those with relapsing–remitting MS, the DHQ total significantly predicted a lower relapse rate and reduced odds of increasing disease activity, but the model fit was poor and the predicted change only marginal. Discussion This study supports significant associations of healthy dietary habits with better physical and mental HRQOL and a lower level of disability. Further research is urgently required to explore these associations including randomized controlled trials of dietary modification for people with MS.
Collapse
Affiliation(s)
- Emily J Hadgkiss
- Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia
- Correspondence to: Emily Hadgkiss, Emergency Practice Innovation Centre, St Vincents Hospital, PO Box 2900, Fitzroy, Melbourne, VIC 3065, Australia.
| | | | | | - Naresh G Pereira
- Faculty of Medicine, Notre Dame University, Fremantle, Western Australia, Australia
| | - Claudia H Marck
- Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia
| | - Dania M van der Meer
- Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia
| |
Collapse
|