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Published on: July 24, 2013
Frailty and Falls in People Living With Multiple Sclerosis
Tobia Zanotto1, Irina Galperin2, Anat Mirelman3
1Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS; Illinois Multiple Sclerosis Research Collaborative, Interdisciplinary Health Science Institute, University of Illinois at Urbana-Champaign, Urbana, IL.
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.
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