Trends of quality of life changes in amyotrophic lateral sclerosis patients

• Published in: Journal of the neurological sciences 2016-09, Vol.368, p.35-40
• Main Authors: Shamshiri, Hosein, Fatehi, Farzad, Abolfazli, Roya, Harirchian, Mohammad Hossein, Sedighi, Behnaz, Zamani, Babak, Roudbari, Ali, Razazian, Nazanin, Khamseh, Fatemeh, Nafissi, Shahriar
• Format: Article
• Language: English
• Subjects: Age Factors; Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - drug therapy; Amyotrophic Lateral Sclerosis - epidemiology; Amyotrophic Lateral Sclerosis - physiopathology; Amyotrophic Lateral Sclerosis - psychology; Disability Evaluation; Disease Progression; Female; Follow-Up Studies; Functional disability; Humans; Iran; Male; Middle Aged; Muscle Strength; Neurology; Neuroprotective Agents - therapeutic use; Physical disability; Prospective Studies; Quality of Life; Riluzole - therapeutic use; Severity of Illness Index; Sex Factors
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2016.06.056

Abstract Background Amyotrophic lateral sclerosis (ALS) is an incurable progressive neurodegenerative disease and thus the assessment of quality of life (QOL) changes and factors that may influence its course is valuable in the meantime. Objectives The present study aimed to assess the deterioration rate of QOL and influencing factors in different subgroups of Iranian ALS patients. Methods 132 patients were evaluated in this prospective multicenter observational study. QOL was measured using ALS Assessment Questionnaire (ALSAQ-40) during 1 year follow up and its progression rate was assessed in different subgroups of patients according to age, sex, stage of disease, riluzole consumption, onset type. Also physical disability and functional disability were measured using MMT and ALSFRS-R scores respectively and their progression rates were compared with ALSAQ-40 changes. Results Significant deterioration of the scores of ALSAQ-40 during study was consistent in all of its domains ( p = 0.000). There was a significant negative correlation between ALSFRS-R and MMT changes and ALSAQ-40 change ( p = 0.000) and this was consistently observed in all domains of ALSAQ-40 ( p = 0.00). ALSAQ-40 deterioration rate was shown to be significantly lower in severe/terminal stages compared to mild/moderate stages ( p = 0.00). Significantly higher deterioration rate was observed in bulbar onset versus limb onset patients [F (1, 130) = 4.52, p = 0.04] but no significant difference was observed among other subgroups according to age, sex and riluzole consumption. Conclusion All domains of QOL significantly deteriorate during ALS course and there is a significant correlation between their changes and progression of physical and functional disabilities. Rate of degradation of QOL may be different at different stages of the disease. QOL worsens independent of factors such as sex, age and consumption of riluzole; but onset type (bulbar versus limb) is an imperative factor in quality of life changes during the disease course.