Fall attributions among middle-aged and older adults with multiple sclerosis

Arch Phys Med Rehabil. 2013 May;94(5):890-5. doi: 10.1016/j.apmr.2012.11.027. Epub 2012 Nov 28.

Abstract

Objectives: To (1) explore the falls attributions of middle-aged and older adults with multiple sclerosis (MS); and (2) examine the personal, health, and MS-related factors associated with the 3 most common attributions.

Design: A cross-sectional, descriptive study using data collected through a telephone interview. Falls attributions were obtained through an open-ended question to elicit participants' stories about their most recent fall. Recruitment was done through a national volunteer MS registry.

Setting: Community.

Participants: People (N=354) who were ≥55 years of age were interviewed; 313 provided a falls story. Respondents were primarily married, community-dwelling women who had been living with MS for 21 years, on average.

Interventions: Not applicable.

Main outcome measures: The 3 most common fall attributions were used as dependent variables to address the second research objective.

Results: A total of 14 falls attributions were identified. The most common were balance (41.5%), lower extremity malfunction (31%), and assistive technology (AT; 29.7%). Falls control was significantly associated with the balance attribution (odds ratio [OR]=.51; 95% confidence interval [CI], .29-.88), no variables were associated with lower extremity malfunction attribution, and use of multiple mobility devices was significantly associated with the AT attribution (OR=3.78; 95% CI, 2.09-6.85).

Conclusions: Findings highlight the complex nature of falls among middle-aged and older adults with MS and point to the need for comprehensive fall prevention interventions for this population. Further investigation of the role that perceived control over falls plays in this population is warranted.

MeSH terms

  • Accidental Falls* / prevention & control
  • Aged
  • Aged, 80 and over
  • Confidence Intervals
  • Cross-Sectional Studies
  • Environment
  • Female
  • Humans
  • Logistic Models
  • Lower Extremity / physiopathology
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / physiopathology
  • Odds Ratio
  • Postural Balance
  • Self-Help Devices / adverse effects
  • Walking