The relationship between depression, anxiety and cognition and its paradoxical impact on falls in multiple sclerosis patients.

Published on Oct 1, 2018in Multiple sclerosis and related disorders4.339
· DOI :10.1016/J.MSARD.2018.07.029
Alon Kalron20
Estimated H-index: 20
(TAU: Tel Aviv University),
Roy Aloni5
Estimated H-index: 5
(Sheba Medical Center),
Gilles Allali38
Estimated H-index: 38
(Geneva College)
Sources
Abstract
Abstract Although falls, cognitive impairments and mood disorders are very common in people with MS (PwMS) the relationship between these conditions has received scant attention. Therefore, the purpose of the study was to investigate the specific involvement of depression and anxiety on cognition and falls in PwMS. The study included 122 PwMS (75 women) divided into four subgroups according to their manifestation of depression and anxiety assessed by the Hospital Anxiety and Depression Scale (HADS) (i.e. no depression/no anxiety, depression/no anxiety, no depression/anxiety and depression/anxiety). Cognitive performance was evaluated via a computerized cognitive battery of tests. Participants were defined as “fallers” and “non-fallers” based on their fall history recorded during a clinical interview. Thirty-eight PwMS (31.1%) were classified as depressed (mean HADS 11.1, SD = 3.4); 52 (42.6%) were classified as anxious (mean HADS 11.1, S.D = 3.1) and 56 (45.9%) were neither depressed nor anxious. PwMS categorized in the anxiety/non-depressed subgroup were 6 times less likely to fall than PwMS without depression or anxiety (OR = 0.160, 95%CI = 0.040–0.646; P-value = 0.010). In terms of global cognitive status, depressed PwMS with anxiety were almost 4 times more likely to experience cognitive impairments compared to PwMS who were not depressed or anxious. Anxiety without comorbid depression is associated with less risk of falling, even when comparing MS patients without depression or anxiety. Future longitudinal investigations should confirm if this phenotype of MS patients with anxiety and without depression fall less compared with other mood groups.
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References33
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Abstract Objective Prevalence rates of depression and anxiety in patients with Multiple Sclerosis (MS) vary widely across studies. Aim of this systematic review and meta-analysis was to a) estimate the prevalence of depression and anxiety in MS, and specifically b) explore sources of heterogeneity (assessment method, prevalence period, study quality, recruitment resource, region) by extensive analyses. Methods A computerized search in PubMed, EMBASE, and PsycINFO for studies on depression and an...
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Background: Anxiety and depression are common in multiple sclerosis (MS). We evaluated the prevalence and factors associated with anxiety, depression and fatigue at the 5-year review of a longitudinal cohort study following a first clinical diagnosis of CNS demyelination (FCD). Methods: Cases with a FCD were recruited soon after diagnosis and followed annually thereafter. A variety of environmental, behavioural and clinical covariates were measured at five-year review. Anxiety and depression wer...
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Abstract Background Multiple Sclerosis (MS) is a chronic neurological disease, which poses significant psychological challenges. The purpose of this systematic review was to identify factors that are associated with anxiety in people with MS (PwMS). It aimed to examine the strength of evidence for factors associated with anxiety symptoms and identify limitations of existing studies. Method and results One hundred and thirty one studies met inclusion criteria and were included in the review. A na...
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Background:There is a high prevalence of depressive and anxiety disorders in multiple sclerosis (MS), a disease 2.5 times more frequent in females. Contrary to the general population, in whom studies have demonstrated higher rates of depression and anxiety in females, little is known about the impact of gender on psychiatric sequelae in MS patients.Objectives:We conducted a retrospective study to try to clarify this uncertainty.Methods:Demographic, illness-related and behavioral variables were o...
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Cognitive impairment, anxiety, and depressive symptoms are common in multiple sclerosis (MS) and are known to interact in non-MS populations. This retrospective chart review examined this relationship in a relapsing-remitting MS population. A significant difference on measures of processing speed/working memory and visual-spatial memory was found in MS patients with anxiety compared with nonanxious MS patients, while a significant difference was found on measures of processing speed, visual-spat...
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Background: Falls are common in people with multiple sclerosis (PwMS). Previous studies have generally included small samples and had varied methods. Objectives: The objectives of this paper are to compile fall rates across a broad range of ages and disease severity and to definitively assess the extent to which MS-associated and demographic factors influence fall rates. Methods: Individual data from studies in four countries that prospectively measured falls for three months were analyzed. We d...
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The aim of this article is to provide recommendations on behalf of the International MS Falls Prevention Research Network (IMSFPRN) for the primary outcome measure for multiple sclerosis (MS) falls-prevention interventions. The article will consider the definition of a fall, methods of measuring falls, and the elements of falls that should be recorded, as well as how these elements should be presented and analyzed. While this information can be used to inform the content of falls-prevention prog...
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Patients with multiple sclerosis (MS) frequently experience depression, which profoundly reduces quality of life, and increases disease mortality. In this Review, Feinstein and colleagues present multiple approaches to the diagnosis and quanitfication of mood disorders, and critically evaluate the various treatment options for MS-related depression.The authors also discuss the extent to which depression can be teased apart from the neurological, immunological and psychosocial sequelae of MS.
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The primary aim was to examine the relationship between seven definite aspects of cognition measured by a computerized cognitive testing tool on the history falls in people with mild to moderate MS (PwMS). Secondary aims focused on whether cognition performance is correlated to fear of falling, walking velocity, and a patient-rated measure of walking ability. One hundred and one PwMS were included in the study analysis. Fifty-two had a history of at least one fall during the past year. Outcome m...
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#2Luca Prosperini (Sapienza University of Rome)H-Index: 32
Last. Davide CattaneoH-Index: 25
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Objective:To determine whether there are demographic, clinical, and instrumental variables useful to detect fall status of patients with multiple sclerosis.Data sources:PubMed and the Cochrane Library.Review methods:Eligible studies were identified by two independent investigators. Only studies having a clear distinction between fallers and non-fallers were included and meta-analysed. Odds ratios (ORs) and standard mean differences (SMDs) were calculated and pooled using fixed effect models.Resu...
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#1Jing Zhong (Tongji University)H-Index: 1
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#1Jenna N Cohen (Yeshiva University)
#2Elizabeth K. Seng (Yeshiva University)H-Index: 17
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Abstract Objective Given the limited research concerning the relationship between depression and falls in multiple sclerosis (MS), this study aimed to examine the direct and indirect association between fall history and depressive symptoms. Methods One hundred and forty seven MS patients had completed at least one neuropsychological assessment that included detailed information regarding fall history, as well as measures of depression, motor function, and cognitive processing speed. Results Fall...
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#1Jordan Hoffmeister (TU: University of Tulsa)H-Index: 2
#2Michael R. Basso (Mayo Clinic)H-Index: 3
Last. Dennis R. Combs (UT Tyler: University of Texas at Tyler)H-Index: 22
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Objective: Cognitive impairment affects as many as 65% of people with multiple sclerosis (PWMS), and memory impairment confers greater severity of disability and functional impairment. Depression is also common among PWMS, and lifetime prevalence rates are as high as 50%. Research has yet to clearly define the relationship between memory dysfunction and depression among PWMS, and may reflect incomplete assessment of depressive symptoms. The present study examined different aspects of depressive ...
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The field of Multiple sclerosis (MS) has entered an area of growth in the understanding of the MS immune dysregulation that has led to an impressive therapeutics expansion. However, results of surveys and proceedings of the American Academy of Neurology (AAN) support the notion that US neurology residents have fragmented exposure to MS training during residency, resulting in learning gaps in diagnosis, management and follow up of patients with MS. There are annual educational offerings by MS aca...
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#1Yue LuH-Index: 1
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#1Jessica Podda (Multiple Sclerosis Foundation)H-Index: 5
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#1Scott Rooney (GCU: Glasgow Caledonian University)H-Index: 5
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#1Michelle D. Tibbs (UCSD: University of California, San Diego)H-Index: 5
#2Minh-Phuong Huynh-Le (UCSD: University of California, San Diego)H-Index: 12
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