Associations of Psychological Distress, Cognitive Function, and Physical Activity with Daily Functioning and Quality of Life Across Disability Levels in Multiple Sclerosis.

Higher levels of depression were associated with lower quality of life scores in participants with mild and moderate disability, particularly in activities of daily living, psychological well-being, and symptoms domains.

• Study included 149 adults with relapsing-remitting MS classified by disability severity using the Patient-Determined Disease Steps (PDDS) scale
• QoL was evaluated using the Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire
• Psychological distress was assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21)
• Associations were identified through stratified comparative analyses within mild, moderate, and severe disability categories
• In those with severe disability, associations between depression and QoL were described as 'less consistent'

Higher anxiety levels were associated with lower quality of life in participants with mild and moderate disability, with less consistent associations observed in the severe disability group.

• Anxiety was one of three psychological distress components measured via DASS-21
• Domains particularly affected included activities of daily living, psychological well-being, and symptoms
• The pattern of association differed across the three disability strata (mild, moderate, severe)
• Cross-sectional design precludes causal inference

Stress remained associated with selected QoL domains even in participants with severe disability, unlike depression and anxiety which showed less consistent associations at that disability level.

• Stress was assessed as a distinct component of the DASS-21 alongside depression and anxiety
• This finding distinguishes stress from the other two psychological distress components in the context of severe disability
• Disability severity was classified as mild, moderate, or severe using the PDDS scale
• The specific QoL domains associated with stress in severe disability are described as 'selected' domains

Higher cognitive function was associated with more favorable quality of life across several domains in people with relapsing-remitting MS.

• Cognitive function was measured using the Montreal Cognitive Assessment (MoCA)
• Favorable associations were observed across 'several domains' of the MusiQoL questionnaire
• Associations were examined within disability severity strata
• The study included 149 adults with RRMS in a cross-sectional design

Greater physical activity was associated with more favorable quality of life across several domains in people with relapsing-remitting MS.

• Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ)
• Favorable QoL associations were observed 'across several domains' of the MusiQoL
• Analyses were stratified by disability level (mild, moderate, severe) using PDDS
• The cross-sectional design does not allow causal inferences to be drawn

The study enrolled 149 adults with relapsing-remitting MS stratified into mild, moderate, and severe disability groups using the Patient-Determined Disease Steps scale.

• This was a cross-sectional study design
• All participants had a diagnosis of relapsing-remitting MS (RRMS)
• Disability severity classification used the Patient-Determined Disease Steps (PDDS) scale
• Multiple instruments were used: DASS-21 for psychological distress, MoCA for cognition, IPAQ for physical activity, and MusiQoL for quality of life
• Stratified comparative analyses were conducted to examine differences in overall and domain-specific QoL