Falls in Older Individuals with and without Multiple Sclerosis

Background: Individuals with MS tend to display a high incidence of falls. However, little is known about the influence of aging on the rates and circumstances surrounding falls in older individuals with MS compared to their age matched counterparts. Further understanding of falls in this segment of the MS population has the potential to inform future fall prevention recommendations.  

Objectives: The aim of this study was to investigate the occurrence and rate of falls in older individuals with MS and age matched controls.

Methods: 24 individuals with MS (age: 61.8yr ± 8.8yr, EDSS: median (IQR) = 6.0(4.5-6.5), years since diagnosis: 18.5yr ± 8.9yr) and 24 age matched controls (age: 63.5yr ± 4.8yr) participated in the investigation. Prospective falls data were obtained through participant self-report over a three-month period with monthly falls diaries. The diaries were mailed back to the laboratory in prepaid envelopes. Participants were instructed to note any time they experienced a fall, which was defined as unintentionally coming to rest on the ground or lower level. The total number of falls, fall rate per month and recurrence were noted for each participant. Group differences in proportion of fallers and recurrent fallers were analyzed with the chi-square test while comparisons of falls and fall rates were determined with Mann-Whitney U tests.

Results: Overall, a total of 104 falls were recorded over the three month period, 97 by the MS group and 7 by the age matched controls. The MS group also fell at a significantly higher rate averaging 1.35 falls/month/person compared to 0.10 falls/month/person for the control group (p<.001). The MS group contained significantly greater proportions of both fallers (75% v. 17%, p<.001) and recurrent fallers (63% v. 4%, p<.001) than the control group.

Conclusions: The findings suggest fall incidences, rates and recurrence in older adults with MS are significantly greater than age matched counterparts. Previous literature has primarily focused on falls in the younger segment of the MS population and the current study serves to expand those observations. Ultimately, the prevalence of falling in older adults with MS highlights the importance of designing high quality fall prevention programs and interventions for this subset of the MS community.