In a recent study published in the journal BMC Neurology researchers found that despite the lack of a curative therapy, Amyotrophic Lateral Sclerosis carergivers (including specialized physicians as well as nursing and familial caregivers) can substantially contribute to the maintenance of quality of life (QoL) at the highest possible level. The study showed that QoL and depressive symptoms should be regularly evaluated and special requirements of patients with different ALS phenotypes should be kept in mind.
Amyotrophic lateral sclerosis (ALS) is a motor neuron condition that causes degeneration of upper and lower motor neurons leading to rapidly progressive paralysis of skeletal muscles, affecting respiratory, speech and swallowing functions. ALS patients have progressive physical impairment and a loss of communication, and there is a lack of treatment options for the condition. Clinical care and management has become a topic of increasing research interest. Improvement of quality of life (QoL) is most relevant as patients with psychological distress have a greater risk of mortality.
Evidence has shown that ALS patients have good QoL despite the progressive physical impairment. However the interaction of disability and depression relative to QoL in ALS patients remains poorly understood particularly regarding the extent progressive physical limitations are related with increased depression and decreased QoL and which other factors are relevant.
In the study titled “Interaction of physical function, quality of life and depression in Amyotrophic lateral sclerosis: characterization of a large patient cohort”, Sonja Körner from the Department of Neurology, Medizinische Hochschule Hannover in Germany all colleagues, characterized 159 ALS patients and looked at the impact of several factors (physical impairment, disease duration, gender, disease onset and age) on depressive symptoms and QoL, using the Beck Depression Inventory-II, the SF-36 Health Survey questionnaire and the revised ALS functional rating scale).
The researchers wanted to elucidate which aspects of QoL are affected in ALS patients and whether there are differences, related to the disease phenotype. Results showed that QoL of ALS patients was reduced in nearly all SF-36-categories and that the progression of physical impairment was correlated with depression but reduced QoL scores only in items directly related to physical function.
Based on these results the team concluded that depressive symptoms have strong influence on QoL, as such their detection and treatment is of particular importance. Different domains of QoL are differently affected in subgroups of ALS patients. According to the researchers, being aware of these differences can be valuable for both ALS professional and family caregivers and physicians.