Influence of multisystemic affection on health-related quality of life in patients with myotonic dystrophy type 1

Abstract

Aim: To assess health-related quality of life (HRQoL) in patients with DM1, to identify muscular, multisystemic, central and social factors that may affect QoL and to define a DM1 patient in risk of poor QoL. Patients and method: This cross-sectional study comprised 120 DM1 consecutive patients. The following scales were used: Multidimensional Scale of Perceived Social Support (MSPSS), Muscular Impairment Rating Scale (MIRS), battery of neuropsychological tests, acceptance of illness scale (AIS), Hamilton rating scale for depression (Ham-D), Krupp's Fatigue Severity Scale (FSS), Daytime Sleepiness Scale (DSS) and SF-36 questionnaire. Results: HRQoL was impaired in DM1 patients in both physical and mental domains (PCS was 41.8 ± 23.5, MCS 47.0 ± 24.3 and total SF-36 score 45.6 ± 24.0). The most significant factors correlating with better SF-36 total score were younger age (β = -0.45, p < 0.001), shorter duration of disease (β = -0.27, p = 0.001), higher education (β = 0.20, p = 0.009), less severe muscular weakness (β = -0.52, p < 0.001), normal swallowing (β = 0.22, p = 0.005), absence of fainting (β = 0.31, p = 0.002), absence of snoring (β = 0.21, p = 0.036), better acceptance of disease (β = -0.17, p = 0.036), lower depressiveness (β = -0.46, p = 0.001), lower fatigue (β = -0.32, p = 0.001), absence of cataract (β = -0.21, p = 0.034), absence of kyphosis (β = 0.31, p = 0.004) and absence of constipation (β = 0.24, p = 0.016). Second linear regression analysis revealed that depressed (β = -0.38, p < 0.001) and elder patients (β = -0.27, p = 0.007) and as well as those with poor acceptance of illness (β = -0.21, p = 0.006) were in especially higher risk of having poor HRQoL (R2 = 0.68). Conclusion: We identified different central, social, muscular, cardiorespiratory and other factors correlating with HRQoL. It is of great importance that most of these factors are amenable to treatment. © 2012 Elsevier B.V.