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Abstract
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OBJECTIVE: To provide an update on risk factors associated with falls and injurious falls among people with multiple sclerosis (PwMS) in the United States.
DESIGN: Nationwide cross-sectional web-based survey SETTING: Community setting PARTICIPANTS: Adult PwMS (n = 965) INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Participants completed self-report surveys of demographics, clinical data, concerns about falling, occurrence of falls, factors associated with falls, and injurious falls in the past 6 months. Participants also completed Patient Reported Outcome Measurement Information System (PROMIS) measures of depression, pain interference, and physical function, and the Fatigue Severity Scale.
RESULTS: The most common self-reported factors associated with falls included personal factors such as poor balance (75%), muscle weakness (54%), and/or fatigue (35%), environmental factors such as general surface conditions (37%) and/or distraction (15%), and activities-related factors such as urgency to complete a task (35%) and/or multitasking (27%). Logistic regression analyses indicated that higher fatigue severity (OR = 1.19, p <0.01) and higher pain interference (OR = 1.02, p <0.01) were associated with higher odds of experiencing at least one fall. Any level of concern, even minimal concern about falling was also significantly associated with a higher odd of experiencing at least one fall (ORs range 2.78 - 3.95, all p <0.01). Fair to very high concerns about falling compared to no concerns about falling (ORs range = 5.17 - 10.26, all p < 0.05) was significantly associated with higher odds of sustaining an injurious fall.
CONCLUSIONS: Findings suggest fall prevention approaches in PwMS should be multifactorial and include personal, environmental, and activities-related factors. Particular attention on fatigue, pain, and concerns about falling may be needed to reduce incidence of falls and injurious falls in this population.
Language: en |