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Gender differences in health-related quality of life in multiple sclerosis

Section of Clinical Neurology and Center for Multiple Sclerosis, Department of Medical and Surgical Sciences of Communication and Behaviour, University of Ferrara, Italy, cti{at}dns.unife.it

Trond Riise

Department of Public Health and Primary Health Care, University of Bergen, Norway

Monica Wamme Nortvedt

Department of Health and Social Research, Bergen University College, Bergen, Norway

Nicola Tiberio Economou

Sleep Research Unit, Psychiatric Clinic, University of Athens, Greece

Riccardo De Gennaro

Section of Clinical Neurology and Center for Multiple Sclerosis, Department of Medical and Surgical Sciences of Communication and Behaviour, University of Ferrara, Italy

Patrik Fazio

Section of Clinical Neurology and Center for Multiple Sclerosis, Department of Medical and Surgical Sciences of Communication and Behaviour, University of Ferrara, Italy

Edward Cesnik

Section of Clinical Neurology and Center for Multiple Sclerosis, Department of Medical and Surgical Sciences of Communication and Behaviour, University of Ferrara, Italy

Vittorio Govoni

Section of Clinical Neurology and Center for Multiple Sclerosis, Department of Medical and Surgical Sciences of Communication and Behaviour, University of Ferrara, Italy

Enrico Granieri

Section of Clinical Neurology and Center for Multiple Sclerosis, Department of Medical and Surgical Sciences of Communication and Behaviour, University of Ferrara, Italy

Women have about twice the risk of developing multiple sclerosis (MS) compared with men, a ratio that seems to be increasing. Most studies show that female patients seem to have a more favourable outcome of the disease. We studied the gender-specific impact of MS on health-related quality of life. We surveyed the population prevalence of MS patients in Ferrara, Italy. Data were extracted from the MS registry of the study area. Health-related quality of life was assessed using the MSQOL54 questionnaire. We analysed 370 patients (105 men and 265 women). They had worse scores than the general population in all health-related quality of life dimensions, ranging from 2.5 standard deviations (SD) lower for physical functioning to less than 0.5 standard deviations for mental health. Health-related quality of life scores were inversely correlated with disability scores. The impact of disability on health-related quality of life was higher for men than women regarding physical functioning (p < 0.01), vitality (p < 0.001), social functioning (p < 0.001), emotional wellbeing (p < 0.05) and mental health (p < 0.01). For scales reflecting mental health, a marked reduction with increasing disability was seen for men, while a linear reduction in the range of Expanded Disability Status Scale score 0—5 was reported for women, followed by no clear decrease for higher scores. We conclude that MS affects health-related quality of life in all of its dimensions. The impact of disability seems to be stronger among men, in particular for scales related to mental well-being. This could indicate that interventions should to be gender specific in order to better meet patients’ needs.

Key Words: multiple sclerosis • health-related quality of life • SF-36 • disability • EDSS • gender

This version was published on November 1, 2009

Multiple Sclerosis, Vol. 15, No. 11, 1339-1346 (2009)
DOI: 10.1177/1352458509107016


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