Recurrent Falls In Older Adults With MS

Background: Falls are a major health concern for persons with multiple sclerosis (MS).  Research focusing on fall risk factors has mainly focused on differences between fallers and non-fallers. However, there is growing evidence from other clinical populations that single and frequent fallers have distinct risk factors. It is not clear what factors distinguish between single and recurrent fallers with MS. 

Objectives: To examine mobility, balance, fall risk and cognition in older adults with multiple sclerosis (MS) as a function of fall frequency. 

Methods: Community dwelling persons with MS (N=27) aged between 50 and 75 years were divided into two groups (single (n=11) and recurrent falls (n=16; > 2 falls/12 months)) based on previous falls history. Mobility was assessed using a variety of measures including, Multiple Sclerosis Walking Scale-12 (MSWS-12), walking speed (Timed 25 Foot Walk), endurance (6-Minute Walk) and coordination (Timed Up and Go). Balance was assessed with the Berg Balance Scale, posturography and self-reported balance confidence. Falls risk was assessed with the physiological profile assessment (PPA). Cognitive processing speed was quantified with the symbol digit modalities test (SDMT) and the paced auditory serial addition test (PASAT).

Results: There was no difference in mobility, balance or fall risk between recurrent and single fallers (p’s > .05; d’s 0.3-0.6). The recurrent fall group had significantly lower scores on both the PASAT (41.9±11.0vs. 51.1±6.1; d = -1.0) and the SDMT (46.4±7.2 vs. 52.9±4.9; d = -1.1) than the single time fall group (p's < 0.01). 

Conclusions: Results indicated that cognitive processing speed is associated with fall frequency and may have implications for fall prevention strategies targeting recurrent fallers with MS.