Multidimensional Predictors of Fatigue in Amyotrophic Lateral Sclerosis: A Cross-Sectional Study in China

Aim: This study aims to identify key predictors of fatigue in patients with amyotrophic lateral sclerosis (ALS) and examine the interaction of physiological, psychological, and social factors to inform management strategies. Design: A descriptive cross-sectional study. Methods: Between June 2023 and June 2024, a cohort of 239 patients diagnosed with ALS enrolled at the Integrated Traditional Chinese and Western Medicine Center, Hubei Provincial Hospital of Traditional Chinese Medicine. The participants were evaluated using validated instruments that assessed motor function, depressive symptoms, sleep quality, and social determinants. A multiple regression analysis was conducted to identify independent predictors of fatigue. Results: The ALS Functional Rating Scale-Revised (ALSFRS-R), depression (PHQ-9), sleep quality (PSQI), and living situation were significant predictors of fatigue, accounting for 28.6% of the variance (R ² =0.286). The use of traditional Chinese medicine was associated with a reduction in fatigue, whereas muscle strength exhibited an inverse correlation with the severity of fatigue. Conclusions: Fatigue in ALS is influenced by multiple factors, extending beyond motor decline to include psychological well-being, sleep quality, and social environment. These findings highlight the need for multidisciplinary, personalized strategies that integrate both biomedical and supportive care approaches to enhance the quality of life for ALS patients.