Physical Functioning Among Older Adults with MS: Evidence Based on an Objective Outcome

Background: There are greater numbers of older adults living with multiple sclerosis (MS) than ever before, and this trend will continue over the foreseeable decades. This growing cohort of older adults with MS undergoes age-related declines in physical functioning that appear to be compounded by the disease and its progression. Of note, older adults with MS report poorer health status and functioning than older adults without MS, but this is based on self-report measures.

Objectives: We compared physical functioning in older adults with MS and an age-matched control group using the Short Physical Performance Battery (SPPB). The SPPB is an extensively-validated objective measure for characterizing lower extremity function in older adults and has recently been validated in older adults with MS.

Methods: The convenience sample included 20 older adults with MS and 20 controls matched on age, sex, height, and weight. All participants completed the SPPB, and those with MS further underwent a neurological examination for generation of an EDSS score. The SPPB includes assessments of balance, gait speed, and lower extremity strength, and those assessments are aggregated into a summary SPPB score.

Results: Among the older adults with MS, the summary SPPB scores ranged between 2 and 12, and the mean SPPB score was 9.4 (SD=2.1). This was significantly lower than the mean scores of 11.6 (SD=0.7) for controls (p<.001), with an effect size that was large in magnitude (d=−1.4). There were statistically significant differences between groups in the assessments of balance (p<.005), gait speed (p<.05), and lower extremity strength (p<.005). The effect sizes were large in magnitude for balance (d=−1.5), gait speed (d=−1.1), and lower extremity strength (d=−1.2).

Conclusions: These data suggest that this sample of older adults with MS exhibited substantially worse physical function than that of a sample of older adults, and the decrements occur across all domains objectively assessed by the SPPB.