OpenLB
Open Library of Bioscience
Advanced Search
Dysphagia
Mar 04, 2025;

The Comparison of Quality of Life in Patients with Mild-Moderate Severity of Multiple Sclerosis with and without Dysphagia.

Azam Rezatofighi, Majid Soltani, Seyed Mahmoud Latifi, Nastaran Majdinasab, Zohre Safari, Matin Varmazyar, Negin Moradi
Author Information
  1. Azam Rezatofighi: Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  2. Majid Soltani: Department of Speech Therapy, Musculoskeletal Rehabilitation Research Center, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. majidsoltanist@gmail.com.
  3. Seyed Mahmoud Latifi: Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  4. Nastaran Majdinasab: Musculoskeletal Rehabilitation Research Center, Professor of Neurology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  5. Zohre Safari: Department of Speech Therapy, Musculoskeletal Rehabilitation Research Center, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  6. Matin Varmazyar: Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
  7. Negin Moradi: Department of Communication Sciences and Disorders, University of Wisconsin-River Falls, Wisconsin-River Falls, USA.
PMID: 40038124 DOI: 10.1007/s00455-025-10811-9

Abstract

Multiple Sclerosis (MS) is a common chronic disease among young adults. It affects various aspects of Quality of Life (QOL). Dysphagia is a problem associated with neurological damage in MS patients. This study aimed to compare MS patients' QOL with and without dysphagia. This is a cross-sectional study performed on 40 patients with MS (20 with and 20 without dysphagia) selected from the MS Society members of Ahvaz, Iran. Research tools included the Persian version of Dysphagia in Multiple Sclerosis (DYMUS), Mini-Mental State Examination (MMSE), and Multiple Sclerosis Quality of Life-54 (MSQOL-54). The data were analyzed by SPSS software version 22 and the Mann-Whitney test. The results showed a significant difference in QOL score amongst patients with and without dysphagia. The QOL score of patients with dysphagia was significantly lower than patients without dysphagia. The main differences in the subscale of the QOL Index were mental component and physical activity. MS patients with dysphagia had lower QOL than patients without it. The results show that the quality of life of MS patients with dysphagia is lower than the quality of life of MS patients without dysphagia, and this issue includes different physical and mental aspects of the quality of life of these patients. According to the findings of this study, it seems that early referral of patients with MS to speech and language pathologists for the management of swallowing disorders in the early stages of the disease can be very important and help improve the wellbeing of these patients and their families.

Keywords

Deglutition Deglutition disorders Dysphagia Mini-mental state examination (MMSE) Multiple sclerosis Multiple sclerosis quality of life-54 (MSQOL-54) Persian version of dysphagia in multiple sclerosis (DYMUS) Quality of life

References

  1. Benito-León J, Manuel Morales J, Rivera-Navarro J, Mitchell AJ. A review about the impact of multiple sclerosis on health-related quality of life. Disabil Rehabil. 2003;25(23):1291–303. [DOI: 10.1080/09638280310001608591]
  2. Aghayousefi A, Shaghaghi F, Dehestani M, Barghi IZ. The Relationship between Quality of Life (QoL) and Psychological Capital with Illness Perception in MS Patients Alireza Yousefi*, Farhad Shaghaghi**, Mehdi Dehestani***, Ziba Barghi Irani***** Associate Professor of Psychology Group in PNU University** Assistant Professor of Psychology Group in PNU University*** Assistant Professor of Psychology Group in PNU University**** Instructor and PhD student in psychology group at PNU university. Quarterly J Health Psychol. 2012;1(1):29–41.
  3. Aghaz A, Alidad A, Hemmati E, Jadidi H, Ghelichi L. Prevalence of dysphagia in multiple sclerosis and its related factors: systematic review and meta-analysis. Iran J Neurol. 2018;17(4):180. [PMID: 31210903]
  4. Alali D, Ballard K, Bogaardt H. The frequency of dysphagia and its impact on adults with multiple sclerosis based on patient-reported questionnaires. Multiple Sclerosis and Rel Disord. 2018;25:227–31. [DOI: 10.1016/j.msard.2018.08.003]
  5. Guan X-L, Wang H, Huang H-S, Meng L. Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurol Sci. 2015;36(5):671–81. [DOI: 10.1007/s10072-015-2067-7]
  6. Solaro C, Rezzani C, Trabucco E, Amato M, Zipoli V, Portaccio E, et al. Prevalence of patient-reported dysphagia in multiple sclerosis patients: an Italian multicenter study (using the DYMUS questionnaire). J Neurol Sci. 2013;331(1–2):94–7. [DOI: 10.1016/j.jns.2013.05.020]
  7. Pajouh SD, Moradi N, Yazdi MJS, Latifi SM, Mehravar M, Majdinasab N, et al. Diagnostic evaluation of dysphagia in multiple sclerosis patients using a Persian version of DYMUS questionnaire. Multiple Sclerosis and Rel Disord. 2017;17:240–3. [DOI: 10.1016/j.msard.2017.08.012]
  8. Calcagno P, Ruoppolo G, Grasso M, De Vincentiis M, Paolucci S. Dysphagia in multiple sclerosis–prevalence and prognostic factors. Acta Neurol Scand. 2002;105(1):40–3. [DOI: 10.1034/j.1600-0404.2002.10062.x]
  9. Barzegar-Bafrooei E, Bakhtiary J, Khatoonabadi AR, Fatehi F, Maroufizadeh S, Fathali M. Validation of the Persian version of the dysphagia handicap index in patients with neurological disorders. Iran J Neurol. 2016;15(3):128. [PMID: 27648173]
  10. Al Rjoob M, Hassan NFHN, Aziz MAA, Zakaria MN, Mustafar MFBM. Quality of life in stroke patients with dysphagia: asystematic review. Tunis Med. 2022;100(10):664. [PMID: 36571750]
  11. Smith R, Bryant L, Hemsley B. The true cost of dysphagia on quality of life: The views of adults with swallowing disability. Int J Lang Commun Disord. 2023;58(2):451–66. [DOI: 10.1111/1460-6984.12804]
  12. Silbergleit A, Konnai R, Schultz LR. Development and validation of the dysphagia handicap index-companion (DHI-C). Dysphagia. 2024. https://doi.org/10.1007/s00455-024-10716-z . [DOI: 10.1007/s00455-024-10716-z]
  13. Jones E, Speyer R, Kertscher B, Denman D, Swan K, Cordier R. Health-related quality of life and oropharyngeal dysphagia: a systematic review. Dysphagia. 2018;33:141–72. [DOI: 10.1007/s00455-017-9844-9]
  14. Jacobsson C, Axelsson K, Osterlind PO, Norberg A. How people with stroke and healthy older people experience the eating process. J Clin Nurs. 2000;9(2):255–64. [DOI: 10.1046/j.1365-2702.2000.00355.x]
  15. Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46. [DOI: 10.1007/s00455-001-0113-5]
  16. Langmore SE. Issues in the management of dysphagia. Folia Phoniatr Logop. 1999;51(4–5):220–30. [DOI: 10.1159/000021499]
  17. Adams R, Crisp DA, Thomas J. The psychological impacts of pill dysphagia: a mixed methods study. Dysphagia. 2024. https://doi.org/10.1007/s00455-024-10703-4 . [DOI: 10.1007/s00455-024-10703-4]
  18. Hermann BP, Vickrey B, Hays RD, Cramer J, Devinsky O, Meador K, et al. A comparison of health-related quality of life in patients with epilepsy, diabetes and multiple sclerosis. Epilepsy Res. 1996;25(2):113–8. [DOI: 10.1016/0920-1211(96)00024-1]
  19. Fernandes AMF, Duprat AdC, Eckley CA, Silva Ld, Ferreira RB, Tilbery CP. Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity? Braz J Otorhinolaryngol. 2013;79:460–5. [DOI: 10.5935/1808-8694.20130082]
  20. Gil-González I, Martín-Rodríguez A, Conrad R, Pérez-San-Gregorio MÁ. Quality of life in adults with multiple sclerosis: a systematic review. BMJ Open. 2020;10(11):e041249. [DOI: 10.1136/bmjopen-2020-041249]
  21. Hemmett L, Holmes J, Barnes M, Russell N. What drives quality of life in multiple sclerosis? QJM. 2004;97(10):671–6. [DOI: 10.1093/qjmed/hch105]
  22. Usta NC, Boz C, Terzi M. Early onset multiple sclerosis and the effect of disease onset age on neurological disability in multiple sclerosis. Clin Neurol Neurosurg. 2023;224:107528. [DOI: 10.1016/j.clineuro.2022.107528]
  23. Romero-Pinel L, Bau L, Matas E, León I, Muñoz-Vendrell A, Arroyo P, et al. The age at onset of relapsing-remitting multiple sclerosis has increased over the last five decades. Multiple Sclerosis and Rel Disord. 2022;68:104103. [DOI: 10.1016/j.msard.2022.104103]
  24. Prosperini L, Lucchini M, Ruggieri S, Tortorella C, Haggiag S, Mirabella M, et al. Shift of multiple sclerosis onset towards older age. J Neurol Neurosurg Psychiatry. 2022;93(10):1137–9. [DOI: 10.1136/jnnp-2022-329049]
  25. Habbestad A, Willumsen JS, Aarseth JH, Grytten N, Midgard R, Wergeland S, et al. Increasing age of multiple sclerosis onset from 1920 to 2022: a population-based study. J Neurol. 2024;271(4):1610–7. [DOI: 10.1007/s00415-023-12047-9]
  26. Mohammad K, Rimaz S, Dastoorpour M, Sadeghi M, Majdzadeh SR. Quality of Life and Related Factors among multiple sclerosis patients. J Sch Public Health and Inst Public Health Res. 2014;11(4):1–14.
  27. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol: Official J Am Neurol Assoc and the Child Neurol Soc. 2001;50(1):121–7. [DOI: 10.1002/ana.1032]
  28. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444. [DOI: 10.1212/WNL.33.11.1444]
  29. Bergamaschi R, Crivelli P, Rezzani C, Patti F, Solaro C, Rossi P, et al. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neurol Sci. 2008;269(1–2):49–53. [DOI: 10.1016/j.jns.2007.12.021]
  30. Jafari Z, Shahbodaghi MR, Maroufizadeh S, Moghadasi AN. Validation of the Persian version of dysphagia in multiple sclerosis questionnaire for the assessment of dysphagia in multiple sclerosis. Iran J Neurol. 2018;17(3):99. [PMID: 30886675]
  31. Langmore SE, Scarborough DR, Kelchner LN, Swigert NB, Murray J, Reece S, et al. Tutorial on clinical practice for use of the fiberoptic endoscopic evaluation of swallowing procedure with adult populations: part 1. Am J Speech Lang Pathol. 2022;31(1):163–87. [DOI: 10.1044/2021_AJSLP-20-00348]
  32. Ghaem H, Haghighi AB, Jafari P, Nikseresht A. Validity and reliability of the Persian version of the multiple sclerosis quality of life questionnaire. Neurol India. 2007;55(4):369–75. [DOI: 10.4103/0028-3886.33316]
  33. Vickrey B, Hays R, Harooni R, Myers L, Ellison G. A health-related quality of life measure for multiple sclerosis. Qual Life Res. 1995;4(3):187–206. [DOI: 10.1007/BF02260859]
  34. Afsharzadeh M, Mirmosayyeb O, Vaheb S, Shaygannejad A, Maracy M, Shaygannejad V. Dysphagia in neuromyelitis optica spectrum disorder and multiple sclerosis: a comparison of frequency, severity, and effects on quality of life. Multiple Sclerosis and Rel Disord. 2024;87:105640. [DOI: 10.1016/j.msard.2024.105640]
  35. Leow LP, Huckabee M-L, Anderson T, Beckert L. The impact of dysphagia on quality of life in ageing and Parkinson’s disease as measured by the swallowing quality of life (SWAL-QOL) questionnaire. Dysphagia. 2010;25(3):216–20. [DOI: 10.1007/s00455-009-9245-9]
  36. Davis LA. Quality of life issues related to dysphagia. Top Geriatr Rehabilit. 2007;23(4):352–65. [DOI: 10.1097/01.TGR.0000299163.46655.48]
  37. Karisik A, Dejakum B, Moelgg K, Komarek S, Toell T, Mayer-Suess L, et al. Association between dysphagia and symptoms of depression and anxiety after ischemic stroke. Eur J Neurol. 2024;31(5):e16224. [DOI: 10.1111/ene.16224]
  38. Kim JY, Lee YW, Kim HS, Lee EH. The mediating and moderating effects of meaning in life on the relationship between depression and quality of life in patients with dysphagia. J Clin Nurs. 2019;28(15–16):2782–9. [DOI: 10.1111/jocn.14907]

Grants

  1. PHT-9625/Ahvaz Jundishapur University of Medical Sciences
Journal Article

Word Cloud

Created with Highcharts 10.0.0patientsMSdysphagiawithoutMultipleQOLSclerosisQualityDysphagiaqualitylifestudyversionlowersclerosisdiseaseaspectsLife20PersianDYMUSMMSEMSQOL-54resultsscorementalphysicalearlydisordersDeglutitioncommonchronicamongyoungadultsaffectsvariousproblemassociatedneurologicaldamageaimedcomparepatients'cross-sectionalperformed40selectedSocietymembersAhvazIranResearchtoolsincludedMini-MentalStateExaminationLife-54dataanalyzedSPSSsoftware22Mann-WhitneytestshowedsignificantdifferenceamongstsignificantlymaindifferencessubscaleIndexcomponentactivityshowissueincludesdifferentAccordingfindingsseemsreferralspeechlanguagepathologistsmanagementswallowingstagescanimportanthelpimprovewellbeingfamiliesComparisonPatientsMild-ModerateSeverityMini-mentalstateexaminationlife-54multiple

Similar Articles

Cited By