Associations Between Bladder Dysfunction and Falls in People with Relapsing-Remitting Multiple Sclerosis

Jaime E. Zelaya, PhD; Charles Murchison, MS; Michelle Cameron, MD, PT

Correspondence: Michelle Cameron, MD, PT, Department of Neurology, Oregon Health & Science University, 3710 SW US Veterans Hospital Rd., Mail Code P3NEUR, Portland, OR 97239; e-mail: cameromi@ohsu.edu.

Background: Bladder dysfunction and falls are common in multiple sclerosis (MS), but associations between these problems are unclear. The purpose of this study was to clarify the association between specific types of bladder dysfunction (urinary urgency, frequency, and incontinence) and prospectively recorded falls in people with MS.

Methods: Fifty-one people aged 18 to 50 years with relapsing-remitting MS and mild-to-moderate disability (Expanded Disability Status Scale [EDSS] score ≤6.0) completed a self-report questionnaire regarding urinary incontinence, urgency, and frequency at baseline and then prospectively recorded their falls daily for 3 months using fall calendars. Participants were classified as recurrent fallers (≥2 falls) or nonrecurrent fallers (<2 falls) for one regression model, and then as fallers (≥1 fall) or nonfallers (0 falls) for another regression model. Associations between baseline bladder dysfunction and faller status were assessed using logistic regression, adjusted for potential confounders of age, gender, and disability.

Results: Fifteen subjects were recurrent fallers, 36 were nonrecurrent fallers, 32 were fallers, and 19 were nonfallers. After adjusting for age, gender, and disability, there was only a significant association between urinary urgency with incontinence and recurrent falls in the following 3 months (OR: 57.57; 95% CI: 3.43–966.05; P =.005).

Conclusions: Urinary urgency with incontinence is associated with recurrent falls in the following 3 months in people with relapsing-remitting MS with mild-to-moderate disability. Further research is needed to better understand mechanisms underlying this association and to evaluate the impact of bladder management programs on falls.