Fall risk is related to cognitive functioning in ambulatory multiple sclerosis patients

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Neuroscience

Background:

• Multiple sclerosis (MS) frequently causes gait disturbance and falls.
• Cognitive dysfunction in MS patients is linked to increased fall rates, independent of physical disability.

Purpose of the Study:

• To determine fall rates and identify risk factors in MS patients.
• To assess the relationship between falls and cognitive dysfunction in MS.
• To monitor patients for falls over a six-month period.

Main Methods:

• 124 patients with relapsing-remitting MS (RRMS) were evaluated.
• Gait, balance, upper extremity function, and fear of falling were assessed using standardized tests (TUG, T25WFT, 9HPT, BBS, FES-I).
• Cognitive function (SDMT), fatigue (FSS), and quality of life (MSQoL) were measured; patients were categorized into fallers and non-fallers.

Main Results:

• 46 patients reported at least one fall in the preceding year.
• Fallers were older, less educated, and had lower Symbol Digit Modalities Test (SDMT) scores and higher disability scores.
• Cognitive function (SDMT) correlated positively with balance (BBS) and dexterity (9HPT) scores.

Conclusions:

• Advanced age, lower education, and cognitive impairment negatively impact gait and balance in MS.
• Lower cognitive scores (SDMT, MoCA) were associated with higher fall rates.
• EDSS and BBS scores predict falls in MS; monitoring falls may indicate cognitive deterioration.