Under-treated depression negatively impacts lifestyle behaviors, participation and health-related quality of life among older people with multiple sclerosis

• Published in: Multiple sclerosis and related disorders Vol. 40; p. 101919
• Main Authors: Ploughman, Michelle, Wallack, Elizabeth M., Chatterjee, Tanaya, Kirkland, Megan C., Curtis, Marie E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.05.2020
• Subjects: Aged; Aging; Antidepressant; Antidepressive Agents - administration & dosage; Canada; Depression; Depression - etiology; Depression - physiopathology; Depression - therapy; Depressive Disorder - etiology; Depressive Disorder - physiopathology; Depressive Disorder - therapy; Diet - statistics & numerical data; Disabled Persons; Exercise; Fatigue - etiology; Fatigue - physiopathology; Female; Health services; Health Surveys; Humans; Life Style; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - physiopathology; Patient Reported Outcome Measures; Psychosocial Intervention; Quality of life; Quality of Life - psychology; Severity of Illness Index; Canada; Antidepressant; Aging; Depression; Multiple sclerosis; Health services; Quality of life
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2019.101919

•44.5% of respondents were diagnosed with depression and/or had depressive symptoms.•Only 12.1% were on antidepressants and 13.8% used psychosocial services.•People with depressive symptoms were younger, male with higher disability and fatigue.•People with treated depression (no symptoms) resembled those without depression.•Depressive symptoms predicted poor lifestyle habits, participation and quality of life. : To what extent depression may negatively impact successful aging with multiple sclerosis (MS) is not known. We examined the impact of depression/depressive symptoms on lifestyle choices (diet, exercise, smoking and alcohol), participation and health-related quality of life (HRQoL) among older people living with MS (n = 742). : Based on self-reported depression diagnosis and scores on the Hospital Anxiety and Depression Scale, we divided the sample into four groups: 1. No depression diagnosis and low symptoms (n = 412), 2. Diagnosed with depression and low symptoms (n = 103), 3. Diagnosed with depression and high symptoms (n = 87), and 4. No depression diagnosis and high symptoms (n = 140). We used regression modelling to predict outcomes, controlling for age, MS disease duration, type of MS at initial diagnosis and disability. : A high proportion (44.5%) reported either being diagnosed with depression, having high levels of symptoms or both. Only 12.1% reported that they were prescribed anti-depressants and 13.6% utilized psychosocial services. Compared to those with depression who had low symptoms, respondents who had high depressive symptoms (n = 227) were more likely to be non-exercisers (OR 1.85, 95%CI 1.02–3.34, p = 0.042), consume a poor diet (OR 2.12, 95%CI 1.27–3.52, p = 0.004), have the lowest levels of participation (OR 3.36, 95%CI 1.74–6.49, p = 0.0003) and report the poorest HRQoL (OR 1.95, 95%CI 1.17–3.26, p = 0.011). Men and people experiencing higher levels of disability and fatigue were at greater risk of having high symptoms and being undiagnosed. : Undiagnosed and under-treated depression is common among older people living with MS and adversely impacts health choices.