Fear of falling and associated activity curtailment among middle aged and older adults with multiple sclerosis

Abstract

The purpose of this study was to identify factors associated with increased likelihood of reporting fear of falling (FoF) among people with multiple sclerosis (MS) and factors associated with activity curtailment among the subset of individuals reporting FoF. Cross-sectional data from telephone interviews with 1064 individuals with MS, aged 45-90 years living in the Midwestern United States were used. Logistic regression models examined factors associated with FoF and with activity curtailment among individuals reporting FoF. Of the participants, 63.5% reported FoF. Increased likelihood of reporting FoF was associated with being female, experiencing greater MS symptom interference during everyday activities, history of a fall in the past 6 months, and using a walking aid. Among participants reporting FoF, 82.6% reported curtailing activity. Increased likelihood of activity curtailment among people reporting FoF was associated with using a walking aid, needing moderate or maximum assistance with instrumental activities of daily living, and having less than excellent self-reported mental health. We concluded that FoF and associated activity curtailment are common among people aged 45-90 with MS. While FoF and associated activity curtailment may be appropriate responses to fall risk, the findings suggest that factors beyond realistic appraisal of fall risk may be operating.

Multiple sclerosis and mobility-related assistive technology: Systematic review of literature

“…When gait difficulties do not respond to therapeutic interventions, MAT devices may be useful tools to enhance mobility [17]. Most persons with MS have mobility restrictions that require MAT devices [9,[20][21].…”

“…These development efforts must consider several symptoms of MS that influence ambulation: loss of balance, weakness, fatigue, cognitive impairment, fear of falling, spasticity, tremor, and visual impairment [17][18]. In addition, resistance to using appropriate MAT must also be addressed.…”

Falls requiring medical attention among veterans with multiple sclerosis: A cohort study

“…Despite falls having been long recognized as common in people with MS [4][5][6] and the significant potential effect of falls for people with MS [19,21], the risk factors are not well understood. Falls in people with MS have been found to be associated with being male [5][6], impaired balance [4][5][6], reduced ability to walk [4][5][6]22], and use of a cane [4] or other walking aid [6].…”

Medications Are Associated with Falls in People with Multiple Sclerosis

“…[4][5][6] Falls in people with MS are associated with injuries 3,7,8 and adversely affect quality of life. 9 Fall risk in MS is generally attributed to impairments in the wide range of functions affected by the disease, including balance, cognition, vision, muscle strength and tone, coordination, and sensation. 10,11 Although there are limited interventions available to modify these endogenous fall risk factors, modifiable exogenous factors may also contribute to fall risk in MS.…”