Frailty and Falls in People Living With Multiple Sclerosis

Abstract

Objective: To explore the association between frailty and history of falls in people living with multiple sclerosis (MS).

Design: Secondary analysis.

Setting: University research laboratories in the United States and Israel.

Participants: A total of 118 people (N=118) with relapsing-remitting MS (mean age, 48.9±10.0 years; 74.6% female; Expanded Disability Status Scale [EDSS] range, 1.0-6.0) were studied in this cross-sectional analysis.

Intervention: Not applicable.

Main outcome measures: A frailty index was calculated from 40 health deficits by following standard validated procedures. The number of falls (12-month history) was recorded.

Results: Overall, 33.9%, 29.7%, and 36.4% of participants were classified as nonfrail, moderately frail, and severely frail, respectively. The frailty index was significantly correlated (ρ=0.37, P<.001) with higher scores on the EDSS. In univariable negative binomial regression analysis, the frailty index was associated with a higher number of falls (incidence rate ratio [IRR]=3.33; 95% CI, 1.85-5.99; P<.001). After adjustment for age, sex, and EDSS, frailty remained strongly associated with history of falls (IRR=2.78; 95% CI, 1.51-5.10; P=.001).

Conclusions: The current study identifies a significant relationship between frailty and history of falls in MS, independent of age, sex, and disease severity. These findings support the notion that frailty is a syndrome related to but independent of disability in MS.

Keywords: Accidental falls; Aging; Frailty; Multiple sclerosis; Rehabilitation.