*3.1. Characteristics of Patients with MS*

126 (84.6%) of the 149 questionnaires distributed in the period from March to September 2018 were completed. Two of the 126 questionnaires were filled out incompletely, resulting in a total of 124 (83.2%) completed questionnaires. There was no significant difference between the groups in terms of age, sex, disease duration, diagnosis, or behavior in coffee consumption (Table 1).


**Table 1.** Patient characteristics.

p, statistical significance; n, number; PPMS, primary progressive multiple sclerosis; r, range; RRMS, relapsing remitting multiple sclerosis; SD, standard deviation; SPMS, secondary progressive multiple sclerosis; y, year.

Nevertheless, the rate of unemployment was significantly higher in patients experiencing fatigue (*p* < 0.001). In total 34.7% (*n* = 43) were not working anymore at the time of filling out the questionnaire. Out of these 43 patients 67.4% (*n* = 29) stated to not be able to work due to their disease. This was accompanied by an increased EDSS value in the group of patients with fatigue (Table 1).

#### *3.2. EDSS*

The clinical classification of patients using the standardized EDSS resulted in a median of 2.5 (*n* = 124). For further analysis, we defined three groups based on the EDSS value (Table 2). The EDSS describes the severity of the disease and is correspondingly higher in more severely affected patients. Group-wise a significant difference in mean age could be seen. The duration of the disease since initial diagnosis also showed clear differences in the groups. There was a significant positive correlation between a higher EDSS value and the mean duration of the illness of the patients (r = 0.493, *p* < 0.001). Coffee consumption did not differ significantly between the groups.

**Table 2.** EDSS distribution of patients with MS.


EDSS, expanded disability status scale, n, number; y, year.

#### *3.3. Fatigue*

As previously described, we formed two groups "fatigue" and "no fatigue", based on the FSS-Score. In comparison, a higher mean EDSS score in patients affected by fatigue could be shown. The group "fatigue" contained 39.1% with an EDSS score of at least four, in contrast to group "no fatigue" with 19.2% (*p* = 0.003). As described above (Table 1), the groups presented themselves as homogeneous regarding most characteristics. Based on this assumption, we compared the different effects and side

effects of coffee and caffeine consumption. As presented in Table 3, the perceived effects of coffee were remarkably similar regarding fatigue.


**Table 3.** Effects of coffee consumption of MS patients without and with fatigue.

MS, multiple sclerosis; n, number.
