Life space assessment and falls in older adults with multiple sclerosis

Roee Holtzer; Robert W Motl; Mark E Wagshul; Mary Ann Picone; Manuel E Hernandez; Meltem Izzetoglu; Michael L Lipton; Frederick W Foley

doi:10.1016/j.msard.2024.105671

Life space assessment and falls in older adults with multiple sclerosis

Mult Scler Relat Disord. 2024 May 6:87:105671. doi: 10.1016/j.msard.2024.105671. Online ahead of print.

Authors

Roee Holtzer¹, Robert W Motl², Mark E Wagshul³, Mary Ann Picone⁴, Manuel E Hernandez⁵, Meltem Izzetoglu⁶, Michael L Lipton⁷, Frederick W Foley⁸

Affiliations

¹ Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States. Electronic address: Roee.Holtzer@yu.edu.
² Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois, Chicago, IL, United States.
³ Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States.
⁴ Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, United States.
⁵ Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, United States; Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois, Urbana-Champaign, Urbana, IL, United States.
⁶ Villanova University, Electrical and Computer Engineering, Villanova, PA, United States.
⁷ Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States; Department of Biomedical Engineering, Columbia University, New York, NY, United States.
⁸ Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, United States; Multiple Sclerosis Center, Holy Name Medical Center, Teaneck, NJ, United States.

PMID: 38728961
DOI: 10.1016/j.msard.2024.105671

Abstract

Background/objective: Falls research in older adults with MS (OAMS) is scarce, and no studies have reported on the association between life-space mobility and falls in this group. Herein, we hypothesized that higher baseline life-space scores would be associated with reduced odds of reporting falls during follow-up, and explored whether the association differed by MS subtype (progressive vs. relapsing-remitting).

Methods: OAMS (n = 91, mean age = 64.7 ± 4.3ys, %female = 66.9,%progressive MS = 30.7) completed the University of Alabama at Birmingham Life-Space-Assessment (UAB-LSA) scale and reported falls during a structured monthly telephone interview during follow-up (mean = 16.39 ± 11.44 months). General Estimated Equations (GEE) models were utilized to determine whether UAB-LSA scores predicted falls during follow-up.

Results: GEE models revealed that higher UAB-LSA scores were associated with a significant reduction in the odds of falling during follow-up (OR = 0.69, p = 0.012, 95 %CI = 0.51 to 0.92). Stratified analyses revealed that this association was significant in progressive (OR = 0.57, p = 0.004, 95 %CI = 0.39 to 0.84), but not relapsing-remitting (OR = 0.93, p = 0.779, 95 %CI = 0.57 to 1.53) MS.

Conclusion: Higher life-space mobility was associated with lower odds of falling among OAMS with progressive subtype. The UAB-LSA may complement existing mobility measures for predicting fall risk.

Keywords: Aging; Falls; Multiple sclerosis; life space mobility.