Table 3.
Associations between regions and other covariates with physical and mental health quality of life (QOL) obtained using multivariable linear regression models.
| Variables | Physical QOL (n = 1,602)a |
Mental health QOL (n = 1,766)b |
|||
|---|---|---|---|---|---|
| Mean differences (95% CI) | p-Value | Mean differences (95% CI) | p-Value | ||
| Region | Australasia | Reference | – | Reference | – |
| Europe | −2.88 (−6.41, 0.65) | 0.110 | 0.27 (−3.52, 4.06) | 0.888 | |
| North America | −1.24 (−3.46, 0.98) | 0.273 | −0.96 (−3.36, 1.43) | 0.431 | |
| Sociodemographic factors | |||||
| Gender | Male | Reference | – | Reference | – |
| Female | 0.67 (−1.54, 2.89) | 0.550 | 1.37 (−1.09, 3.83) | 0.276 | |
| Age (10 years) | −1.37 (−2.36, −0.38) | 0.007 | 3.05 (1.94, 4.16) | <0.001 | |
| Marital status | Married/cohabiting/partnered | – | – | Reference | – |
| Single | – | – | −2.81 (−5.62, −0.01) | 0.049 | |
| Separated/divorced/widower | – | – | −3.26 (−6.27, −0.24) | 0.034 | |
| Employment status | Employed full or part time | Reference | – | Reference | – |
| Student or stay at home carer | −1.00 (−3.77, 1.77) | 0.478 | −1.43 (−4.48, 1.61) | 0.356 | |
| Unemployed | −6.29 (−9.69, −2.88) | <0.001 | −9.90 (−13.54, −6.26) | <0.001 | |
| Retired due to age or disability | −13.20 (−15.49, −10.92) | <0.001 | −7.11 (−9.61, −4.62) | <0.001 | |
| Education level | No school/primary/secondary | Reference | – | Reference | – |
| Vocational training | 0.89 (−1.76, 3.55) | 0.510 | 1.30 (−1.57, 4.17) | 0.374 | |
| Bachelor degree | 3.66 (1.40, 5.93) | 0.002 | 1.73 (−0.71, 4.17) | 0.164 | |
| Postgraduate | 3.08 (0.57, 5.59) | 0.016 | 2.20 (−0.52, 4.92) | 0.113 | |
| Disease characteristics | |||||
| Years since diagnosis (quartiles) | Less than 3 years | Reference | – | Reference | – |
| 4–6 years | 0.35 (−2.05, 2.75) | 0.775 | −0.37 (−2.98, 2.24) | 0.781 | |
| 7–12 years | −2.96 (−5.36, −0.56) | 0.016 | −1.14 (−3.76, 1.48) | 0.392 | |
| 13 years and above | −2.82 (−5.40, −0.23) | 0.033 | −1.38 (−4.24, 1.47) | 0.343 | |
| Type of MS | Relapsing-remitting | – | – | Reference | – |
| Primary progressive | – | – | −2.28 (−6.11, 1.54) | 0.242 | |
| Secondary progressive | – | – | −2.99 (−6.23, 0.25) | 0.070 | |
| Progressive relapsing | – | – | −5.50 (−12.24, 1.24) | 0.109 | |
| Benign | – | – | 5.37 (0.59, 10.16) | 0.028 | |
| Unsure/other | – | – | −1.88 (−4.69, 0.94) | 0.191 | |
| Current disease modifying medication use | No current DMD use | Reference | – | Reference | – |
| Less than 12 months | −2.53 (−5.07, 0.02) | 0.052 | −3.24 (−6.03, −0.44) | 0.023 | |
| More than 12 months | −1.14 (−3.03, 0.76) | 0.240 | −1.96 (−4.11, 0.20) | 0.075 | |
| Modifiable lifestyle factors | |||||
| Smoking status | Never | Reference | – | Reference | – |
| Former | −0.87 (−2.66, 0.92) | 0.339 | −2.30 (−4.22, −0.37) | 0.020 | |
| Current | −7.77 (−10.61, −4.93) | <0.001 | −7.14 (−10.27, −4.02) | <0.001 | |
| Alcohol consumption | Low | Reference | – | Reference | – |
| Moderate and high | 3.66 (1.91, 5.41) | <0.001 | 2.42 (0.52, 4.32) | 0.013 | |
| Physical activity level | Low | Reference | – | Reference | – |
| Moderate | 9.39 (7.37, 11.42) | <0.001 | 4.53 (2.33, 6.72) | <0.001 | |
| High | 15.05 (12.93, 17.18) | <0.001 | 6.97 (4.63, 9.30) | <0.001 | |
| Vitamin D supplementation | None | Reference | – | Reference | – |
| 1–5,000 IU | −0.45 (−2.87, 1.97) | 0.714 | 0.99 (−1.63, 3.61) | 0.458 | |
| >5,000 IU | 0.64 (−2.26, 3.55) | 0.665 | 1.77 (−1.39, 4.92) | 0.272 | |
| Omega 3 supplementation type | None | Reference | – | Reference | – |
| Fish oil | 1.79 (−0.32, 3.89) | 0.096 | 0.62 (−1.66, 2.89) | 0.594 | |
| Flaxseed oil | 3.10 (−0.18, 6.37) | 0.064 | 1.44 (−2.09, 4.97) | 0.424 | |
| Both fish oil and flaxseed oil | 3.04 (0.33, 5.75) | 0.028 | −0.29 (−3.19, 2.60) | 0.842 | |
| Meditation frequency | Never | Reference | – | Reference | – |
| Less than once per week | −1.36 (−3.48, 0.77) | 0.212 | −2.59 (−4.88, −0.30) | 0.027 | |
| 1–4 times per week | −2.23 (−4.62, 0.16) | 0.068 | 0.21 (−2.37, 2.79) | 0.874 | |
| 5 or more times per week | −1.52 (−4.46, 1.43) | 0.313 | 2.56 (−0.66, 5.77) | 0.119 | |
| Social support | 0 or 1 support person | Reference | – | Reference | – |
| 2 or more support people | 4.42 (2.52, 6.32) | <0.001 | 7.15 (5.10, 9.19) | <0.001 | |
| Body mass index (kg/m2) | Normal | Reference | – | Reference | – |
| Underweight | 2.22 (−2.05, 6.49) | 0.309 | 2.38 (−2.11, 6.87) | 0.298 | |
| Overweight | −3.03 (−5.14, −0.91) | 0.005 | −3.24 (−5.54, −0.94) | 0.006 | |
| Obese | −5.74 (−8.08, −3.40) | <0.001 | −4.50 (−7.03, −1.98) | <0.001 | |
| Dietary habits score (10 U) | 2.05 (1.16, 2.94) | <0.001 | 2.23 (1.27, 3.20) | <0.001 | |
| Latitude (10°) | −0.69 (−2.33, 0.95) | 0.407 | −1.24 (−3.03, 0.56) | 0.176 | |
Complete case analysis was used.
aAnalyses consisted of 66.7% participants. Marital status was not included as a covariate in the model as it is not directly associated with physical quality of life (26), and type of MS was not considered to be confounders in this model.
bAnalyses consisted of 73.6% participants.