Skip to main content
Erschienen in: Quality of Life Research 2/2022

06.07.2021

Does depression in multiple sclerosis mediate effects of cognitive functioning on quality of life?

verfasst von: Tara A. Crouch, Hannah E. Reas, Christina M. Quach, Thane M. Erickson

Erschienen in: Quality of Life Research | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Patients with multiple sclerosis (MS) are at significant risk for decreased quality of life (QoL), in part due to factors such as cognitive impairment and depression. However, objective versus subjective assessments of cognitive functioning may differentially predict QoL, and it remains unknown whether they each impact QoL through levels of depression. The aims of the present study included (1) testing the effects of cognitive impairment on MS-related QoL via depression symptoms and (2) examining whether perceived and objective cognitive functioning differentially predict QoL through depression.

Methods

Patients formally diagnosed with MS (N = 128) participated in cognitive assessment (Brief International Cognitive Assessment for Multiple Sclerosis) and completed self-report measures of perceived cognitive functioning (perceived deficits questionnaire), depression (Hospital Anxiety and Depression Scale), and MS-related QoL (functional assessment of multiple sclerosis).

Results

Mediational hypotheses were tested by regression and structural equation modeling. As hypothesized, both perceived and objective cognitive functioning independently predicted lower QoL controlling for the effects of depression (p < 0.001). Consistent with hypotheses, depression mediated effects of both perceived (95% CI [0.31, 0.68]) and objective cognitive functioning (95% CI [0.09, 6.96]) on QoL when tested in separate models. However, when both predictors were modeled simultaneously, depression only mediated the effects of perceived (not objective) cognitive functioning (95% CI for standardized effect [0.10, 0.61]).

Conclusions

This study, thus, suggests the need to conceptualize different pathways by which objective and subjective cognitive impairment may shape QoL in the lives of individuals with MS.
Literatur
1.
Zurück zum Zitat Javůrková, A., Zimová, D., Tomašovičová, K., & Raudenská, J. (2016). Cognitive deficits and neuropsychological assessment in multiple sclerosis. In A. Gonzalez-Quevedo (Ed.), Trending topics in multiple sclerosis (pp. 211–226). InTech. https://doi.org/10.5772/63968 Javůrková, A., Zimová, D., Tomašovičová, K., & Raudenská, J. (2016). Cognitive deficits and neuropsychological assessment in multiple sclerosis. In A. Gonzalez-Quevedo (Ed.), Trending topics in multiple sclerosis (pp. 211–226). InTech. https://​doi.​org/​10.​5772/​63968
6.
Zurück zum Zitat Sprangers, M. A., de Regt, E. B., Andries, F., van Agt, H. M., Bijl, R. V., de Boer, J. B., Foets, M., Hoeymans, N., Jacobs, A. E., Kempen, G. I. J. M., Miedema, H. S., Tijhuis, M. A. R., & de Haes, H. C. J. M. (2000). Which chronic conditions are associated with better or poorer quality of life? Journal of Clinical Epidemiology, 53, 895–907. https://doi.org/10.1016/S0895-4356(00)00204-3CrossRefPubMed Sprangers, M. A., de Regt, E. B., Andries, F., van Agt, H. M., Bijl, R. V., de Boer, J. B., Foets, M., Hoeymans, N., Jacobs, A. E., Kempen, G. I. J. M., Miedema, H. S., Tijhuis, M. A. R., & de Haes, H. C. J. M. (2000). Which chronic conditions are associated with better or poorer quality of life? Journal of Clinical Epidemiology, 53, 895–907. https://​doi.​org/​10.​1016/​S0895-4356(00)00204-3CrossRefPubMed
8.
Zurück zum Zitat Benedict, R. H., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., & Weinstock-Guttman, B. (2005). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231, 29–34. https://doi.org/10.1017/S1355617706060723CrossRefPubMed Benedict, R. H., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., & Weinstock-Guttman, B. (2005). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231, 29–34. https://​doi.​org/​10.​1017/​S135561770606072​3CrossRefPubMed
11.
23.
Zurück zum Zitat Kinsinger, S. W., Lattie, E., & Mohr, D. C. (2011). Relationship between depression, fatigue, subjective cognitive impairment, and objective neuropsychological functioning in patients with multiple sclerosis. Neuropsychology, 24, 573–580. https://doi.org/10.1037/a0019222CrossRef Kinsinger, S. W., Lattie, E., & Mohr, D. C. (2011). Relationship between depression, fatigue, subjective cognitive impairment, and objective neuropsychological functioning in patients with multiple sclerosis. Neuropsychology, 24, 573–580. https://​doi.​org/​10.​1037/​a0019222CrossRef
26.
Zurück zum Zitat Langdon, D. W., Amato, M. P., Boringa, J., Brochet, B., Foley, F., Fredrikson, S., Hämäläinen, P., Hartung, H. P., Krupp, L., Penner, I. K., Reder, A. T., & Benedict, R. H. (2012). Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS). Multiple Sclerosis Journal, 18, 891–898. https://doi.org/10.1177/1352458511431076CrossRefPubMed Langdon, D. W., Amato, M. P., Boringa, J., Brochet, B., Foley, F., Fredrikson, S., Hämäläinen, P., Hartung, H. P., Krupp, L., Penner, I. K., Reder, A. T., & Benedict, R. H. (2012). Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS). Multiple Sclerosis Journal, 18, 891–898. https://​doi.​org/​10.​1177/​1352458511431076​CrossRefPubMed
27.
28.
Zurück zum Zitat Ritvo, P. G., Fischer, J. S., Miller, D. M., Andrews, H., Paty, D. W., & LaRocca, N. G. (1997). Multiple sclerosis quality of life index: A user’s manual. National Multiple Sclerosis Society. Ritvo, P. G., Fischer, J. S., Miller, D. M., Andrews, H., Paty, D. W., & LaRocca, N. G. (1997). Multiple sclerosis quality of life index: A user’s manual. National Multiple Sclerosis Society.
33.
Zurück zum Zitat Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press.
34.
Zurück zum Zitat Arbuckle, J. L. (2014). Amos 23.0 user’s guide. IBM SPSS. Arbuckle, J. L. (2014). Amos 23.0 user’s guide. IBM SPSS.
35.
Zurück zum Zitat Kline, R. B. (2016). Principles and practice of structural equation modeling (4th ed.). Guilford Press. Kline, R. B. (2016). Principles and practice of structural equation modeling (4th ed.). Guilford Press.
37.
Zurück zum Zitat Ruvalcaba-Romero, N. A., Fernández-Berrocal, P., Salazar-Estrada, J. G., & Gallegos-Guajardo, J. (2017). Positive emotions, self-esteem, interpersonal relationships and social support as mediators between emotional intelligence and life satisfaction. Journal of Behavior, Health & Social Issues, 9(1), 1–6. https://doi.org/10.1016/j.jbhsi.2017.08.001CrossRef Ruvalcaba-Romero, N. A., Fernández-Berrocal, P., Salazar-Estrada, J. G., & Gallegos-Guajardo, J. (2017). Positive emotions, self-esteem, interpersonal relationships and social support as mediators between emotional intelligence and life satisfaction. Journal of Behavior, Health & Social Issues, 9(1), 1–6. https://​doi.​org/​10.​1016/​j.​jbhsi.​2017.​08.​001CrossRef
39.
Zurück zum Zitat Kletenick, I., Alvarez, E., Honce, J. M., Valdez, B., Vollmer, T. L., & Medina, L. D. (2019). Subjective cognitive concern in multiple sclerosis is associated with reduced thalamic and cortical gray matter volumes. Multiple Sclerosis Journal—Experimental, Translational and Clinical, 5, 1–9. https://doi.org/10.1177/2055217319827618CrossRef Kletenick, I., Alvarez, E., Honce, J. M., Valdez, B., Vollmer, T. L., & Medina, L. D. (2019). Subjective cognitive concern in multiple sclerosis is associated with reduced thalamic and cortical gray matter volumes. Multiple Sclerosis Journal—Experimental, Translational and Clinical, 5, 1–9. https://​doi.​org/​10.​1177/​2055217319827618​CrossRef
Metadaten
Titel
Does depression in multiple sclerosis mediate effects of cognitive functioning on quality of life?
verfasst von
Tara A. Crouch
Hannah E. Reas
Christina M. Quach
Thane M. Erickson
Publikationsdatum
06.07.2021
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 2/2022
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-021-02927-w

Weitere Artikel der Ausgabe 2/2022

Quality of Life Research 2/2022 Zur Ausgabe