Addressing the High Risk of Falls in People with Multiple Sclerosis

                                                                  

By Gloria Arminio Berlinski, MS
Reviewed by Aaron Miller, MD, Professor of Neurology, Icahn School of Medicine at Mount Sinai and Medical Director at the Corinne Goldsmith Dickinson Center for Multiple Sclerosis, New York, NY

Intervention programs targeting key modifiable risk factors are vital to preventing falls in people with multiple sclerosis (MS). Research in this field is relatively new, however, and much more work is needed to explore, improve and substantiate prevention strategies.1,2Because falls in MS patients may lead to potentially life-changing consequences, from physical injury to a fear of falling, diminished physical activity, and social isolation,1 they are “a major problem that requires focused attention,” says Marcia Finlayson, PhD, OT Reg (Ont), OTR, Director of the School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada. And “since falls are multifactorial, solutions need to be multifactorial, as well,” she adds.

A significant health concern

“Over the last decade, researchers have gained an improved understanding of fall risk factors in persons with MS,” says Jacob J. Sosnoff, PhD, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL. “Nearly 50 risk factors…have been found to be associated with falls in persons with MS.”

These fall-related variables in MS include, for example, impaired balance, difficulty dual tasking, inconsistent use of mobility devices, reduced strength and sensation, and changes in vision, notes Dr. Finlayson. “One of the most predictive factors for a future fall is having a history of a previous fall in the past year.”

As a result of the numerous mobility challenges and other disease-related issues, people with MS fall at high rates and experience falls substantially more often than community-dwelling older adults, the most studied group in fall prevention programs, Dr. Finlayson says. To illustrate, approximately 33% of older adults fall during a 12-month period, whereas fall rates among people with MS range from 40% over 1 to 2 months to 70% over 12 months, according to both retrospective and prospective reports, she adds.

Strides in intervention research

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