Symptoms as Correlates of Health-Related Quality of Life in Black and White Individuals With Multiple Sclerosis

Abstract

Background: Health-related quality of life (HRQOL) is a key health outcome and often compromised in people with multiple sclerosis (MS). Yet the associations between symptoms and HRQOL across racial subgroups remain unclear. To that end, this cross-sectional, comparative study examined symptoms as correlates of HRQOL in Black and White individuals with MS. Methods: Black (n = 136) and White (n = 273) individuals with MS completed an online survey assessing walking impairment (12-Item Multiple Sclerosis Walking Scale [MSWS-12]), fatigue (Fatigue Severity Scale [FSS]); depression and anxiety (Hospital Anxiety and Depression Scale [HADS-A and HADSD]); and HRQOL (12-Item Short Form Survey Physical and Mental). Bivariate correlations and stepwise linear regression were performed to identify associations between symptoms and HRQOL. Results: MSWS-12, FSS, and HADS-D were significantly associated with physical HRQOL, and HADS-A, HADS-D, and FSS were significantly associated with mental HRQOL within both groups: Black (r range, –0.65 to –0.33; P < .01) and White (r range, –0.68 to –0.30; P < .01) individuals with MS. Regression analyses identified MSWS-12 and FSS as significant correlates of physical HRQOL in both groups (P < .05) after controlling for age and household income. For mental HRQOL, HADS-A and HADS-D were significant correlates among White participants (P < .05), whereas HADS-A was the only significant correlate among Black participants (P < .01) after controlling for age and disease duration. Conclusions: Our findings highlight symptoms, including walking impairment, fatigue, anxiety, and depression, as correlates of HRQOL among Black and White individuals with MS and may inform intervention development that targets the symptoms to improve HRQOL across racial groups.