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Does cognitive performance explain the gap between physiological and perceived fall-risk in people with multiple
Tobia Zanotto1, Danya Pradeep Kumar2, Daniel Golan3
1Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Mobility Core, University of Kansas Centre for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA; Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA.
Cognitive performance does not explain the mismatch between how people with multiple sclerosis (pwMS) physically function and their perceived fall risk. Nearly 30% of pwMS showed this discordance, but cognitive scores were similar across groups.
Area of Science:
- Neurology
- Neuroscience
- Rehabilitation Medicine
Background:
- Cognitive impairment is a known risk factor for falls in people with multiple sclerosis (pwMS).
- The relationship between cognitive function and the discrepancy between physiological fall risk and perceived fall risk in pwMS remains unclear.
- Understanding this relationship is crucial for fall prevention strategies in pwMS.
Purpose of the Study:
- To investigate the association between cognitive performance and the concordance/discordance of physiological and perceived fall risk in pwMS.
- To determine if cognitive deficits contribute to the mismatch between actual fall risk and an individual's awareness of their fall risk.
- To explore cognitive domain performance in relation to different categories of fall risk perception.
Main Methods:
- A cross-sectional analysis was conducted on 201 pwMS.
- Physiological fall risk was assessed using gait speed, and perceived fall risk was measured by the Modified Falls Efficacy Scale.
- Participants were classified into four groups based on physiological and perceived fall risk: high/high, high/low, low/low, and low/high.
- Cognitive performance was evaluated using the NeuroTrax computerized cognitive battery, yielding a global cognitive score (GCS) and domain-specific scores.
Main Results:
- Approximately 27.4% of pwMS demonstrated a discordance between their physiological and perceived fall risk.
- No significant differences in global cognitive scores (GCS) or individual cognitive domain scores were found between individuals with discordant fall risk and those with concordant fall risk.
- Among participants with concordant fall risk, those in the high physiological-high perceived fall risk group exhibited poorer cognitive performance (GCS) compared to the low physiological-low perceived fall risk group.
Conclusions:
- A notable proportion of pwMS (approximately one in four) experience a discrepancy between their objective physical fall risk and their subjective perception of fall risk.
- Cognitive performance, as measured by the NeuroTrax battery, does not appear to be the explanatory factor for this observed discordance in fall risk perception among pwMS.
- Further research may be needed to identify other factors contributing to the misalignment between physiological and perceived fall risk in this population.
