ALS Patients’ Quality of Life Impacted By Psychological Factors

Researchers at the University Medical Center Utrecht recently studied quality of life among people with amyotrophic lateral sclerosis (ALS) and found that anxiety and depression impact poorer health related quality of life (HRQoL), while higher levels of religiosity and spirituality are associated with better overall (global) quality of life (QoL).

The research paper, “Associations between psychological factors and health-related quality of life and global quality of life in patients with ALS: a systematic review,” was published in Health and Quality of Life Outcomes.

ALS is a neurodegenerative disease that affects motor neurons and is associated with progressively worsened motor symptoms that include muscle wasting and weakness of limbs. But because no cure is currently available, treatment comes with symptom management and support for better of quality of life. Behavioral and cognitive deficits are considered for improving QoL.

For ALS, it is been suggested that quality of life measurement should consist of both the overall QoL and the more narrow HRQoL. Assessment of HRQoL includes physical, psychological and social factors; global QoL is appraised by the patient via non-medical concepts such as family, friends and support system. HRQoL typically declines during the disease course as expected, while global QoL can remain stable even in more advanced ALS patients.

Because global QoL can be attributed to psychological processes that include coping, reframing expectations and spiritual or religious practice, researchers believe psychological factors may be important targets for QoL interventions.

For the present study, researchers collected and analyzed existing literature on psychological factors and its influence on HRQoL and global QoL; 22 studies were included in the review. the researchers clustered the psychological factors into three main groups: mood related to states such as anxiety, depression and anger; beliefs, which relate to one’s perception of disease and coping strategies; and personality.

Results support that higher levels of anxiety and depression lead to poorer HRQoL, but religiosity and spirituality correlated positively with better global QoL — and became more positive over time.

Researchers concluded: “This review supports the importance of psychological factors with regard to ALS care. Further research is needed to supplement the available evidence and to investigate how psychological factors can be modified to improve QoL.”