Factors influencing healthy aging with multiple sclerosis: a qualitative study

Abstract

Purpose: The purpose of this study was to describe the factors influencing healthy aging from the perspective of the older person with multiple sclerosis (MS) in order to build curricula for MS self-management programs. Method: We sourced participants, older than 55 years with MS for more than 20 years, from a database of MS clinic and outpatient rehabilitation visits. Recruitment continued until data saturation was reached (n = 18). Semi-structured interviews explored perspectives on aging and health and lifestyle habits. Demographic, lifestyle and perceived health status information was also gathered. We analyzed the transcribed text for themes and theme relationships. Results: Work and social engagement, effective and accessible health care, healthy lifestyle habits, and maintaining independence at home were found to be critical proximal factors for healthy aging. The presence of financial flexibility, social support, cognitive and mental health, and resilience provided a supporting foundation to these critical proximal factors. These factors comprised a two-tiered model of healthy aging with MS. Conclusions: This two-tiered conceptual model of health aging, based on the perspectives of older persons with MS, provides a potential framework for the development of MS self-management program curricula aimed at optimizing quality of life. Further empirical testing may validate its utility in predicting healthy aging with MS.

Implications for Rehabilitation

• The views of older people with Multiple Sclerosis (MS), as experts in managing the long term challenges of living with MS, should be considered in the design of self-management programs.

• Health care, social engagement, lifestyle and independence make critical contributions to health-related quality of life among older people with MS.

• This contribution depends on less-commonly addressed factors: financial flexibility, mental and cognitive health, resilience and social support.

• Strategies that target factors are important components of a comprehensive approach to rehabilitation and self-management of MS.

Keywords::

• coping
• multiple sclerosis
• quality of life
• self-care

Declaration of interest: This research was supported by the Eastern Health Authority, the Dr. W.A. Ingram Award, Faculty of Medicine, Memorial University, and a Fellowship award (M.P.) from the Canadian Institutes of Health Research.