Understanding falls in Multiple Sclerosis: Association of mobility status, concerns about falling, and accumulated impairments

Objective. Falls among persons with multiple sclerosis (MS) are a serious health concern; the percentage of people restricting activity due to concerns about falls is not known. Both mobility function and accumulated impairments are associated with fall risk in older adults, but not in those with stroke. This study; 1) estimated the percentage of people with MS reporting falls, concerns about falling (CAF) and associated activity restrictions (AR), and examined the associations among these factors and fall status; 2) explored the association between fall status and both mobility function and number of accumulated impairments. Design. Cross-sectional survey. Methods. 575 people with MS completed a survey providing information about sociodemographics, falls, CAF, AR, mobility function and accumulated impairments. Chi-square statistics explored the associations among these factors. Results. Among all participants, 61% reported CAF and 67% reported AR. Among non-fallers, 25.9% reported CAF and 27.7% reported AR. Mobility function was associated with fall status (P < .001); the highest percentage of people reporting falls were those with moderate mobility restrictions, the lowest percentage were those with the highest level of mobility restriction. Falls were associated with accumulated impairments (P< .001), with the highest percentage of those with 10 impairments reporting 2 or more falls. Conclusions. CAF and AR are common in persons with MS, even in non-fallers. The association between fall status and mobility appears curvilinear; while fall risk increases with declining mobility function, at a certain threshold, further declines may be associated with reduced falls, possibly due to reduced fall risk-exposure.