Medications Are Associated with Falls in People with Multiple Sclerosis

Cameron, Michelle; Karstens, Lisa; Hoang, Phu; Bourdette, Dennis; Lord, Stephen R.

doi:10.7224/1537-2073.2014-076

Cited by 15 publications

(17 citation statements)

References 34 publications

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“…Additionally, when considering a faller as an individual with two or more falls, centrally acting muscle relaxant medications were also associated with an increased odds of being a faller. Our results are consistent with Nilsagard et al 7 who found no association between number of medications and falls in pwMS but contrast with Gunn et al 8 and Cameron et al 9 who showed this association to be significant. Notably their samples had fewer people with progressive MS.…”

Section: Discussionsupporting

confidence: 92%

Medication usage and falls in people with multiple sclerosis

et al. 2017

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There is a need to identify modifiable risk factors for falls in people with multiple sclerosis (MS) to enable the design of successful falls prevention interventions. There is conflicting evidence regarding the association between medication use and occurrence of falls in MS. A total of 101 people with MS had medications classified using the Anatomical Therapeutic Classification system and number of falls prospectively monitored for 3 months. No association was noted between number of medications and falls. The use of genitourinary and sex hormones (odds ratio (OR) = 5.154, 95% confidence interval (CI) = 1.427-18.609, p = 0.012) and centrally acting muscle relaxant (OR = 5.181, 95% CI = 1.546-17.364, p = 0.008) medications were associated with an increased odds of being a faller.

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Section: Discussionsupporting

confidence: 92%

Medication usage and falls in people with multiple sclerosis

et al. 2017

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“…Consistent with our prior findings in an HIV-infected population [5], women had higher rates of falls than men in the overall population, even after adjusting for additional fall risk factors. In the multivariable analyses, HIV serostatus was not indepen-dently associated with falls, suggesting that the trend towards a higher fall rate among HIV-infected participants seen in previous studies may be attributable to an increased burden of fall risk factors such as comorbidities and greater number of medications [28,29] rather than HIV itself, as indicated by the lack of independent association with HIV serostatus, current or nadir CD4 count, viral load or ART. Indeed, the strongest independent predictors of falls in all participants were symptoms of dizziness, lightheadedness and feeling off-balance, which were reported more frequently among the HIV-infected men and women.…”

Section: Discussionmentioning

confidence: 64%

Fall frequency and associated factors among men and women with or at risk for HIV infection

et al. 2016

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Background Falls and fall-related injuries are a major public health concern. HIV-infected adults have been shown to have a high incidence of falls. Identification of major risk factors for falls that are unique to HIV or similar to the general population will inform development of future interventions for fall prevention. Methods HIV-infected and uninfected men and women participating in a Hearing and Balance Sub-study of the Multicenter AIDS Cohort Study and Women’s Interagency HIV Study were asked about balance symptoms and falls during the prior 12 months. Falls were categorized as 0, 1, or ≥ 2; proportional odds logistic regression models were used to investigate relationships between falls and demographic and clinical variables and multivariable models were created. Results 24% of 303 HIV-infected participants reported ≥1 fall compared to 18% of 233 HIV-uninfected participants (p=0.27). HIV-infected participants were demographically different from HIV-uninfected participants, and were more likely to report clinical imbalance symptoms (p≤0.035). In univariate analyses, more falls were associated with hepatitis C, female sex, obesity, smoking, and clinical imbalance symptoms, but not age, HIV serostatus, or other comorbidities. In multivariable analyses, female sex and imbalance symptoms were independently associated with more falls. Among HIV-infected participants, smoking, number of medications, and imbalance symptoms remained independent fall predictors while current protease inhibitor use was protective. Discussion Similar rates of falls among HIV-infected and uninfected participants were largely explained by a high prevalence of imbalance symptoms. Routine assessment of falls and dizziness/imbalance symptoms should be considered, with interventions targeted at reducing symptomatology.

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“…While CAM users are more likely to perceive herbs and supplements as a natural and safe alternative to conventional medications (Salamonsen, 2015), excessive use of supplements can lead to toxicity and has been associated with serious neurologic and systemic disease (Evans et al, 2018;Kim et al, 2019). Further, polypharmacy is more common in pwMS (Frahm et al, 2019) and higher utilization of both prescription medications and supplements increase the risk of injurious falls (Cameron et al, 2015). Our study demonstrates increased use of supplements in those also using other forms of CAM.…”

Section: Discussionmentioning

confidence: 68%