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Two healthy lifestyle scores are associated with lower subsequent fatigue risk using inverse probability weighting in an international longitudinal cohort of people with multiple sclerosis

Citation

Weiland, TJ and Nag, N and De Livera, A and Jelinek, GA and Neate, SL and Bevens, W and Simpson-Yap, S, Two healthy lifestyle scores are associated with lower subsequent fatigue risk using inverse probability weighting in an international longitudinal cohort of people with multiple sclerosis, European Journal of Neurology, 28, (9) pp. 2952 - 2964. ISSN 1351-5101 (2021) [Refereed Article]

Copyright Statement

Copyright 2021 European Academy of Neurology

DOI: doi:10.1111/ene.14956

Abstract

Background and purpose: Several modifiable lifestyle factors have been associated with the onset and health outcomes of multiple sclerosis (MS), including clinically significant fatigue. A combined lifestyle score approach represents one method of assessing their relationship with clinical outcomes. The aim was to examine the association of two lifestyle scores with clinically significant fatigue and change thereof over 2.5 years' follow-up using inverse probability treatment weighting (IPTW).

Methods: Data on sociodemographic, lifestyle, and clinical characteristics surveyed from an international cohort of people with MS at baseline and at 2.5-year follow-up were used. Fatigue was defined by the Fatigue Severity Scale (FSS >5) and healthy lifestyle by the Healthy Lifestyle Index Score (HLIS) and the Smoking, Nutrition, Alcohol Consumption and Physical Activity (SNAP) score. Analyses were by IPTW accounting for age, sex, MS type, disability, treated comorbidity number, immunomodulatory medication use, prescription antifatigue medication use, and ongoing relapse symptoms.

Results: In total, 1268 participants completed the FSS at both time points; approximately 62% had fatigue. Using doubly robust IPTW, high (>11/20) HLIS (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.81-0.98) and high (>3/5) SNAP (OR 0.82, 95% CI 0.73-0.90) were each associated with lower risk of fatigue at follow-up. Evaluating change in fatigue, a higher SNAP score was associated with a lower risk of fatigue (OR 0.89, 95% CI 0.80-0.97) but the score for HLIS did not reach statistical significance (OR 0.93, 95% CI 0.85-1.01).

Conclusion: These results suggest a robust role for key lifestyle factors in preventing clinically significant fatigue and may represent a place for lifestyle modification in improving clinical outcomes in MS.

Item Details

Item Type:Refereed Article
Keywords:epidemiology, fatigue, inverse probability treatment weighting, lifestyle, multiple sclerosis
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Behavioural epidemiology
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Simpson-Yap, S (Dr Steve Simpson JR)
ID Code:146799
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-09-28
Last Modified:2022-08-23
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