Factors Associated with Physical and Cognitive Fatigue in Patients With Crohnʼs Disease: A Cross-sectional and Longitudinal Study
Abstract
BACKGROUND: Fatigue commonly impairs quality of life in patients with Crohn's disease (CD). This study aimed to evaluate the prevalence and severity of fatigue in CD (compared with ulcerative colitis [UC] and healthy controls) and to identify potentially modifiable factors associated with global, physical, and cognitive dimensions of fatigue. METHODS: Clinic attendees with confirmed CD or UC and healthy volunteers were surveyed on fatigue (Fatigue Impact Scale, FIS), psychological comorbidity, sleep quality, medication, and other clinical information. A CD subgroup also completed a similar follow-up survey. RESULTS: In 379 responders (181 CD, 113 UC, and 85 controls), global, physical, and cognitive FIS scores were highest in CD followed by UC and controls (P < 0.01), with a prevalence of global fatigue (total FIS ≥ 40) in 57% of CD patients. On multivariate analysis, concurrently active disease, poor sleep quality, and mental illness were significantly associated with all the 3 fatigue dimensions: regular vitamin B group supplementation was inversely associated with physical fatigue in the CD cohort and those of older age or with previous resection(s) (P = 0.05) were independently associated with cognitive fatigue only. Longitudinally in CD, fatigue scores remained constant between original and follow-up surveys (mean change in total FIS score +0.9; 95% confidence interval, -4.6 to 6.3). Factors independently associated with improved physical fatigue between surveys included avoidance of corticosteroids and establishment of regular exercise and with improved cognitive fatigue included cessation of immunomodulator therapy. CONCLUSIONS: Fatigue is highly prevalent and more severe in CD. Anticipated and novel associations with improvement of physical and/or cognitive fatigue were identified, offering clues to potential therapeutic approaches to ameliorating fatigue for clinical evaluation.
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Nine of 13 studies found significantly higher rates and/or levels of depression in IBD participants than in healthy controls.
“Nine found significantly higher rates and/or levels of depression in IBD participants than in healthy controls (n=3,517 IBD; n=12,212 controls) (9, 15, 16, 19-22, 24, 26).”
From Controversies Revisited: A Systematic Review of the Comorbidity of Depression and Anxiety with Inflammatory Bowel Diseases (2016) · cites this paper as [26]
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- Authors
- van Langenberg, D. R., & Gibson, P. R.
- Affiliations
- Monash University (AU)
- ORCID
- Gibson, Peter R.
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-01
- Volume
- 20
- Issue
- 1
- Pages
- 115-125
- ISSN
- 1078-0998 (ISSN-L)
- OpenAlex
- W2016357672
- Cited by
- 76
- References
- 51
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 9 · 2018: 3 · 2017: 3 · 2016: 14 · 2015: 4 · 2014: 1
- FWCI
- 4.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- Crohn's disease, ulcerative colitis
- MeSH terms
- Adolescent, Adult, Aged, Cognition Disorders, Colitis, Ulcerative, Crohn Disease, Cross-Sectional Studies, Fatigue, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Prognosis, Quality of Life, Surveys and Questionnaires, Risk Factors, Comorbidity, Case-Control Studies, Young Adult
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