Self-reported fatigue impact is associated with frequency of falls and injurious falls in people with multiple sclerosis.

Abstract

Fatigue is the most common symptom associated with multiple sclerosis (MS). Fatigue as a risk factor for injurious falls and frequency of falls is understudied. Falling recurrently is associated with injurious falls which may lead to reduced functional independence and poor quality of life of people with MS. Identifying contributors of recurrent falls and injurious falls is clinically useful to develop effective interventions. To investigate the associations between fatigue impact and frequency of falls and injurious falls in people with MS. Fifty-one participants completed the Modified Fatigue Impact Scale (MFIS) and a survey of number of falls and injurious falls during the past year. Logistic regression analyses were conducted to investigate whether scores on the MFIS (Total, Physical, Cognitive, and Psychosocial) predicted odds of being a recurrent faller (> 2 falls) or infrequent faller (1- 2 falls) versus a non-faller, and odds of experiencing an injurious fall (yes/no). The analyses were adjusted for demographic and clinical characteristics and common symptoms of MS (depression, cognition, pain, and sleep disturbance). Higher MFIS Total score was associated with higher odds of infrequent falls (OR=1.07, 95% CI, 1.00 - 1.15, p=0.05) and recurrent falls (OR=1.10, 95% CI, 1.00 - 1.20, p=0.04) relative to not falling in the past year. Higher scores on the MFIS Physical subscale were significantly associated with high odds of infrequent falls (OR=1.15, 95% CI, 1.02 - 1.30, p=0.03) and recurrent falls (OR=1.19, 95% CI, 1.02 - 1.39, p=0.03). MFIS Psychosocial subscale was significantly associated with higher odds of infrequent falls (OR=2.01, 95% CI, 1.14 - 3.53, p=0.02). MFIS Total and MFIS Cognitive subscale were significantly associated with higher odds of injurious falls (OR=1.11, 95% CI, 1.00 - 1.23, p=0.04) and (OR=1.28, 95% CI, 1.02 - 1.60, p=0.04), respectively. The findings indicated self-reported fatigue impact and its specific domains were associated with an increased risk of falling and injurious falls. Further studies using prospective falls assessment and longitudinal evaluation of fatigue are warranted to extend our findings.