Development and Usability of MSafe: A Fall Risk Application for Older Adults with Multiple Sclerosis

Background: Falls are highly prevalent in older adults with Multiple Sclerosis (MS) and stem from a complex interplay of physiological, psychosocial, cognitive, and environmental risk factors. Fall risk assessments rely on in-person visits and occur infrequently, but mobile technology can provide portable, cost-effective, and multifactorial screening. The purpose of this study was to develop and evaluate the usability of a multifactorial fall risk app (MSafe) for older adults with MS. Methods: MSafe consists of 37 self-report questions, 9 quantitative cognitive and mobility assessments, and a final fall risk report. One-on-one semi-structured interviews were conducted with 21 older adults (>55) with MS. Participants independently used MSafe, were asked about their likes and dislikes, and completed the System Usability Scale (SUS). Interviews were video-recorded, transcribed, and coded into themes. Results: Three themes emerged: (1) simplicity of use, (2) progress monitoring, and (3) guidance and support. Overall, participants found MSafe easy to use, valuable to track and monitor their fall risk, and either confirmed or increased awareness of their own abilities. SUS scores averaged 84.9 ± 14.7. Conclusions: MSafe is a comprehensive fall risk app that demonstrated high usability by older adults with MS. Future steps include implementing MSafe in home settings to examine fall risk management.