Risk Factors for Falls in Patients with MS

Falls are common among patients with multiple sclerosis (MS), with more than half of patients reporting falls over a three-month period. A study sought to identify risk factors for falls among patients with MS to help with targeted prevention strategies.

Final analysis consisted of 100 patients with MS who had an Expanded Disability Status Score between 3.0 and 6.5. Potential predictors of falls were the Timed Up and Go (TUG) test, the Symbol Digit Modalities test, demographics, and a 15-question self-reported assessment that included information on fatigue, concentration, dual tasking, and bladder and bowel control. Falls were recorded in three-month prospective diaries. The main outcome was the rate of falls.

During a three-month period, 791 falls were reported in 56 patients; the per person-year falls rate was 32.08 falls. Upon multivariable regression analysis, the model with the highest clinical utility and discriminative ability levels incorporated history of a fall, not having visual problems, problems with bladder control, and slower TUG speed. This model had a sensitivity of 88% and an area under the receiving operating curve statistic of 0.72 (95% confidence interval, 0.62-0.82).

“Future implications of this research include the need to repeat this study on an independent sample and externally validate this model. The validation study would need to include a larger and more representative sample including people with MS of various subtypes from a variety of acute, rehabilitation, and primary care settings,” the researchers said of their results.