Functional Decline is Associated with Hopelessness in Amyotrophic Lateral Sclerosis (ALS)

OBJECTIVE: To determine the relationships between hopelessness, depression, quality of life, and disease progression in ALS. METHODS: Hopelessness and depression were assessed prospectively in a cohort of people with ALS using the Beck Hopelessness scale (BHS) and the ALS Depression Inventory (ADI-12), respectively. ALS Specific Quality of Life and measures of functional status (ALSFRS-R and forced vital capacity) were collected. Associations between changes in psychological health and functional scores were calculated using Spearman correlation coefficients. RESULTS: Twenty-five people with ALS had at least 2 visits and were followed for a mean of 11 (± 6) months. People with hopelessness and depression reported worse quality of life (p<0.01 for both associations). Decline in function between any two visits measured by ALSFRS-R (p<0.01) and FVC (p=0.02) correlated with increased hopelessness, but not depression. CONCLUSION: This study highlights the importance of monitoring hopelessness in ALS, particularly in patients with faster functional decline.