Depression, fatigue, and lack of physical activity are associated with decreased bone mineral density in patients with MS and replete vitamin D level, researchers report.
In ambulatory patients with multiple sclerosis (MS) who have adequate vitamin D stores, depression, fatigue, and a lack of moderate physical activity are associated with decreased femoral and lumbar bone mineral density, according to research presented at the 24th Annual Meeting of the Consortium of Multiple Sclerosis Centers.
Alexander Ng, PhD, Associate Professor of Exercise Science, Marquette University, Milwaukee, and colleagues examined 23 patients with MS and 22 healthy controls. Study participants underwent Dual Energy X-ray Absorptiometry (DEXA) of femoral, neck, lumbar, and total body, and resting supine EKGs. In addition, data were collected with use of the MS Functional Composite Measure, Expanded Disability Status Scale (EDSS), Fatigue Impact Scale, and Beck Depression Inventory, and levels of salivary cortisol and serum vitamin D were measured.
Depression and Fatigue in Patients With MS
The researchers found that patients with MS reported greater levels of depression and fatigue than did controls, and subjects also had lower MS Functional Composite Measure scores. No differences were observed between subjects and controls in measures of vitamin D, cortisol, mineral bone density, or heart rate variability.
Levels of moderate but not total physical activity differed between the two groups. Moderate activity was directly correlated to femoral bone mineral density in the MS group, but not in controls. EDSS also correlated to femoral bone mineral density. Depression and fatigue both correlated with femoral and lumbar bone mineral density in the MS group but not in controls.
“Young women and men with MS are at an increased risk for decreased bone mineral density, which, if combined with decreased balance, could lead to an increased risk of bone fractures due to falling or otherwise,” Dr. Ng told Neurology Reviews.
“Appropriate weight-bearing exercise of moderate intensity in persons with MS could be an effective nonpharmacologic countermeasure to this bone mineral density risk,” he added.
The Benefits of Exercise
"Exercise is already recommended for persons with MS for fitness and health risk reduction,” he continued. “Maintaining or increasing bone density is yet another potential benefit of exercise for persons with MS. Intense or hard exercise may not be necessary to improve bone mineral density, although easy exercise may not provide enough of an osteogenic stimulus.”
—Rebecca K. Abma