Factors that impact health-related quality of life in neuromyelitis optica spectrum disorder: anxiety, disability, fatigue and depression

Neuromyelitis optica spectrum disorder (NMOSD) is associated with reduced health-related quality of life (HRQOL). This study aimed to investigate factors that impact HRQOL in NMOSD.A series of questionnaires were completed by 73 patients to assess the relationships between HRQOL and fatigue, depression, anxiety and sleep disorder. We also evaluated the contributions of clinical characteristics to HRQOL. Correlation and regression analysis were conducted to identify factors that negatively impact HRQOL in NMOSD.Pearson's correlation analysis showed that reduced HRQOL was strongly correlated with anxiety (r=-0.77, P=0.000), fatigue (r=-0.75, P=0.000) and depression (r=-0.73, P=0.000); and moderately correlated with disability (r=-0.53, P=0.000) and sleep disorder (r=-0.59, P=0.000). Stepwise regression analysis further revealed that anxiety was the best predictor of both the global and physical composite scores of HRQOL, followed by disability, fatigue and depression (global composite, r(2)=0.76, P=0.000; physical composite, r(2)=0.71, P=0.000). Depression, fatigue and anxiety were the main predictors of the mental health composite score of HRQOL (r(2)=0.69, P=0.000). Other factors did not have an effect on HRQOL.This study revealed factors that impact HRQOL in NMOSD and provided the first demonstration that anxiety, disability, fatigue and depression are independent predictors of poor HRQOL in NMOSD.