Multipl Sklerozlu Bireylerde Yorgunluk Belirleyicilerinin Tanımlanması

Abstract

Amaç: Bu çalışma, multipl sklerozlu (MS) bireylerde yorgunluğun belirleyicilerini; engellilik düzeyi, fiziksel performans, uykululuk ve depresyon gibi klinik ve demografik faktörleri değerlendirerek tanımlamayı amaçlamaktadır. Gereç ve Yöntem: Bu kesitsel çalışmaya toplam 747 pwMS dahil edilmiştir. Yorgunluk, Modifiye Yorgunluk Etki Ölçeği (MYEÖ) kullanılarak değerlendirilmiştir. Yorgunluğun belirleyicilerini tanımlamak amacıyla toplam MYEÖ skoru ve alt boyutları (fiziksel, bilişsel, psiko-sosyal) temel alınarak çoklu doğrusal regresyon analizleri yapılmıştır. Bağımsız değişkenler; yaş, hastalık süresi, atak sayısı, hastalık modifiye edici tedavi (DMT) sayısı, Genişletilmiş Engellilik Durum Ölçeği (EDSS) skoru, Zamanlı 25 Adım Yürüme Testi (Z25AYT), Dokuz Delikli Peg Testi (DDPT), Epworth Uykululuk Ölçeği (EUÖ) ve Beck Depresyon Envanteri (BDE) idi. Bulgular: Daha yüksek EDSS skoru (β=0,191, p<0,001), daha fazla uykululuk seviyesi (ESS, β=0,188, p<0,001) ve daha yüksek depresyon skorları (BDI, β=0,556, p<0,001) ile yüksek yorgunluk skorlarının anlamlı şekilde ilişkili olduğu bulundu. Daha yavaş yürüme performansı (Z25AYT) da anlamlı ancak daha zayıf bir yordayıcı olarak bulundu (β=-0,09, p=0,02). Benzer sonuçlar MYEÖ alt boyutlarında da gözlemlendi. DMT sayısı, hastalık süresi, atak sayısı ve DDPT performansı anlamlı yordayıcılar değildi. Sonuç: Engellilik düzeyi, uykululuk ve depresyon, MS’li bireylerde yorgunluğun en belirgin yordayıcıları olarak öne çıkmıştır. Bu bulgular, yorgunluk yönetim stratejilerinde fiziksel, psikolojik ve uyku ile ilişkili değerlendirmelerin bütüncül şekilde ele alınmasının önemini vurgulamaktadır.

Keywords

• Multipl skleroz
• yorgunluk
• depresyon
• uykululuk

Defining the Predictors of Fatigue in People with Multiple Sclerosis

Abstract

Objective: This study aimed to define the predictors of fatigue in people with multiple sclerosis (MS, pwMS) by evaluating clinical and demographic factors, including disability level, physical performance, sleepiness, and depression. Material and Methods: A total of 747 pwMS were included in this cross-sectional study. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and multiple linear regression analyses were performed to determine the predictors of fatigue based on total MFIS and its subdomains (physical, cognitive, psychosocial). Independent variables included age, disease duration, number of relapses, number of disease-modifying therapies (DMTs), Expanded Disability Status Scale (EDSS) score, Timed 25-Foot Walk (T25FW), Nine-Hole Peg Test (N-HPT), Epworth Sleepiness Scale (ESS), and Beck Depression Inventory (BDI). Results: Higher fatigue scores were significantly associated with increased EDSS scores (β=0.191, p<0.001), greater sleepiness (ESS, β=0.188, p<0.001), and higher depression scores (BDI, β=0.556, p<0.001). Slower walking performance (T25FW) was also a significant but weaker predictor (β=-0.09, p=0.02). Similar patterns were observed across MFIS subdomains. Number of DMTs, disease duration, number of relapses, and N-HPT performance were not significant predictors. Conclusion: Disability level, sleepiness, and depression were the most prominent predictors of fatigue in pwMS. These findings emphasize the importance of integrating physical, psychological, and sleep-related assessments into comprehensive fatigue management strategies for pwMS.

Keywords

• Multiple sclerosis
• fatigue
• depression
• sleepiness

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