Self-reported Impairment Research Articles

Inner speech is used to mediate short-term memory, but not planning, among intellectually high-functioning adults with autism spectrum disorder

Evidence regarding the use of inner speech by individuals with autism spectrum disorder (ASD) is equivocal. To clarify this issue, the current study employed multiple techniques and tasks used across several previous studies. In Experiment 1, participants with and without ASD showed highly similar patterns and levels of serial recall for visually presented stimuli. Both groups were significantly affected by the phonological similarity of items to be recalled, indicating that visual material was spontaneously recoded into a verbal form. Confirming that short-term memory is typically verbally mediated among the majority of people with ASD, recall performance among both groups declined substantially when inner speech use was prevented by the imposition of articulatory suppression during the presentation of stimuli. In Experiment 2, planning performance on a tower of London task was substantially detrimentally affected by articulatory suppression among comparison participants, but not among participants with ASD. This suggests that planning is not verbally mediated in ASD. It is important that the extent to which articulatory suppression affected planning among participants with ASD was uniquely associated with the degree of their observed and self-reported communication impairments. This confirms a link between interpersonal communication with others and intrapersonal communication with self as a means of higher order problem solving.

Validation of a new patient-generated questionnaire for quality of life in an urban sample of elder residents

To provide evidence for the validity of the Fragebogen zur Lebensqualität multimorbider älterer Menschen (FLQM; English: Quality of life in elders with multimorbidity), a new tool for the assessment of life-satisfaction as a subjective indicator of quality of life in old age. The FLQM measures overall life-satisfaction based on those self-generated domains in life that are most important to the respondent. Construct validity (correlations with convergent and divergent scales) and differential validity (subgroup differences with respect to age and limitations in everyday functioning) were analyzed in an urban sample of older adults (n=299; 54.6% male; Mean (age)=75.65years, SD=6.57). Correlations of FLQM with measures of similar constructs were close (r=0.35-0.50; p<0.001). There were no age-group differences. However, subjects with self-reported impairment in functioning scored significantly lower on the FLQM. Also, the relationship between FLQM and self-rated health was close (r=0.44; p<0.001). The FLQM is a valid assessment of older peoples' life-satisfaction. The focus on domains of utmost individual importance seems to link the FLQM to self-rated health more closely than other ratings of global life-satisfaction. Further investigation into the qualitative information obtained by the FLQM is desirable in order to explain individual compositions of life-satisfaction and overall quality of life.

A preliminary predictive model for wheelchair use 4 months after receipt

Objectives: To explore whether use of wheeled mobility devices 4 months after receipt can be predicted based on the type of information available at the time of initial wheelchair prescription/provision across diverse settings and providers. Design: Longitudinal cohort study. Setting: One private teaching hospital and one Department of Veterans Affairs Medical Center. Participants: 86 consecutive, community-dwelling, cognitively intact persons with a wide range of diagnoses newly prescribed a wheeled mobility device. Interventions: Provision of a manual or motorized wheelchair, or scooter. Measurements: The dependent variable was self-reported device use (any versus none) 4 months after initial prescription; independent variables were self-reported medical conditions and impairment, activity limitations, personal and environmental contextual factors. Results: More than half (56.8%) of the subjects were still using their new wheeled mobility device 4 months after receipt. In bivariate analysis, persons still using the device were significantly ( p< 0.05) more likely to report that they had experienced confusion intheprior 6months, that their doctor had toldthem theyhad mental problems such as depression/and or anxiety, or that amputation was the reason they were prescribed a wheelchair. They were less likely to report being hospitalized in the previous 6 months. In the final multivariable model, based on stepwise regression, a history of recent confusion or prior amputation significantly increased the odds of continued device use (Odds Ratio (OR) 6.8 and 14.4 respectively) while recent hospitalization or prior fracture significantly decreased the odds (OR 0.15 and 0.30 respectively). An Index predicting wheelchair use, using weights for these 4 variables based on the multivariable regression, was significantly related to device use in 100 bootstrap replicate samples, with an average beta = 1.03, OR = 2.80, p< 0.001. Depending on the specific combination of variables, the sensitivity of the Index ranged from 0.07 to 0.94 for predicting wheelchair use and the specificity of the Index ranged from 0.27 to 0.99. Conclusions: Although preliminary, the study shows that it is possible to provide evidence-based prediction for short-term use of a new wheeled mobility device, based on information likely to be available at the outset.

The circumstances of older people in England with self-reported visual impairment: A secondary analysis of the English Longitudinal Study of Ageing (ELSA)

One key challenge to those charged with tackling the social exclusion of visually impaired people is having information about the extent to which visual impairment is related to the ability to enjoy and participate in various aspects of life. Using data from the English Longitudinal Study of Ageing (ELSA), this article considers how self-reported visual impairment is related to older people’s physical health and cognitive abilities, their economic and housing conditions, their social engagement, as well as their emotional well-being and life-satisfaction. We find self-reported poor vision to be associated with multiple disadvantages in those outcome measures. Further research is needed to establish causal links between visual impairment and the various health, economic, social and emotional well-being experiences documented in this article. Nevertheless, secondary data analysis of ELSA offers a useful and cost-effective research approach.

Validity of hearing impairment calculation methods for prediction of self-reported hearing handicap

Worker's compensation for hearing loss caused by occupational noise exposure is calculated by varying methods, from state to state within the United States (US), with many employing arithmetic formulas based on the pure-tone audiogram, to quantify hearing loss. Several assumptions unsupported or weakly supported by empirical data underlie these formulas. The present study evaluated the ability of various arithmetic hearing impairment calculations to predict a self-reported hearing handicap in a sample of presenting with sensorineural hearing loss. 204 adults (127 male, 77 female) ranging in age from 18 to 94 served as participants. The sample was selected to exclude patients who had been referred for hearing testing for a medicolegal examination or a hearing conservation appointment. A hearing handicap was measured by the Hearing Handicap Inventory for Adults/for the Elderly (HHIA/E). The covariance analysis of linear structural equations was used to assess the relative strength of correlation with the HHIA/E score among the six formulas and various forms of pure-tone average. The results revealed that all the hearing impairment calculations examined were significantly, but weakly, correlated with the self-reported hearing impairment scores. No significant differences among the predictive abilities of the impairment calculations were evident; however, the average binaural impairment assigned differed significantly among the six calculations examined. Individuals who demonstrated 0% impairment had significantly lower (i.e., better) HHIA/E scores compared to those with non-zero impairment for each formula. These results supported the idea that audiometric data provided an insufficient explanation for real-world hearing difficulties.

Confirmatory Factor Analysis of the Motor Unified Parkinson’s Disease Rating Scale

The motor examination section of the unified Parkinson's disease rating scale (UPDRS) is widely used in research but few studies have examined whether subscales exist that tap relatively distinct motor abnormalities. We analyzed data from 193 persons enrolled in a population-based study in Central California. Patients were examined after overnight PD medication washout (“OFF” state) and approximately one hour after taking medication (“ON” state). We performed confirmatory factor analysis of the UPDRS for OFF and ON state examinations; correlations, reliability, and relative validity of resulting subscales were evaluated. A model with five factors (gait/posture, tremor, rigidity, bradykinesia affecting the left extremities, bradykinesia affecting the right extremities) fit the data well, with similar results for OFF and ON states. Internal consistency reliability coefficients were 0.90 or higher for all subscales. The gait/posture subscale most strongly discriminated across levels of patient reported PD symptom severity and of how PD affects them on a daily basis. Compared to the right sided bradykinesia subscale, the left sided bradykinesia subscale had higher discrimination across levels of self-reported PD symptom severity and functional impairment. This supports motor UPDRS containing multiple subscales that can be analyzed separately and provide information distinct from the total score that may be useful in clinical studies.

Weight Status in Persons with Multiple Sclerosis: Implications for Mobility Outcomes

The accumulation of excess body weight may have important health and disease consequences for persons with multiple sclerosis (MS). This study examined the effect of weight status on mobility using a comprehensive set of mobility outcomes including ambulatory performance (timed 25-foot walk, T25FW; 6-minute walk, 6MW; oxygen cost of walking, Cw; spatiotemporal parameters of gait; self-reported walking impairment, Multiple Sclerosis Walking Scale-12 (MSWS-12); and free-living activity, accelerometry) in 168 ambulatory persons with MS. Mean (SD) BMI was 27.7 (5.1) kg/m2. Of the 168 participants, 31.0% were classified as normal weight (BMI = 18.5–24.9 kg/m2), 36.3% were classified as overweight (BMI = 25.0–29.9 kg/m2), and 32.7% were classified as obese, classes I and II (BMI = 30–39.9 kg/m2). There were no significant differences among BMI groups on T25FW and 6MW, Cw, spatiotemporal gait parameters, MSWS-12, or daily step and movement counts. The prevalence of overweight and obesity in this sample was almost 70%, but there was not a consistent nor significant impact of BMI on outcomes of mobility. The lack of an effect of weight status on mobility emphasizes the need to focus on and identify other factors which may be important targets of ambulatory performance in persons with MS.

Long-term health states relevant to young persons with stroke living in the community in southern Stockholm – a study of self-rated disability and predicting factors

Purpose: The purpose was to explore self-rated long-term disability and to analyze whether initial stroke-related, personal and environmental factors can predict disability in a population-based sample of community-dwelling young (<65 years) persons suffering a stroke in 2000–2006. Method: Data on initial stroke-related, personal and environmental factors were retrieved from medical records. A study-specific posted questionnaire was used. Results: Of the 158 young persons with stroke, 78% had suffered a mild stroke. Tiredness was the most commonly reported mental impairment (86%) followed by impaired memory (67%). A majority reported limitations/restrictions in returning to leisure activities (58%) and work (52%). Stroke-related, personal and environmental factors failed to predict self-reported mental and physical impairments, but predicted activity limitations/participation restrictions with an acceptable power of accuracy (0.70–0.73) but a low sensitivity (0.28–0.59). Conclusions: A majority of these young persons were diagnosed with a mild stroke but experienced long-term mental impairments and activity limitations/participation restrictions that could not be predicted by initial stroke-related, personal and environmental factors solely. Therefore, regular long-term assessments irrespective of initial stroke severity are warranted in order to identify disabilities and improve the state of health among young persons with stroke when needed.Implications for RehabilitationA majority of young persons with stroke are diagnosed with a mild stroke but experience long-term disability that cannot be predicted by initial stroke-related factors solely.Regular long-term assessments are warranted in order to identify disabilities and improve the state of health among young persons with stroke.

English

Chronic idiopathic polyneuropathy (CIP) is a disease of the elderly where further follow-up is usually not indicated after diagnosis. The aim of the study was to evaluate the self-reported functioning and well-being in patients with CIP in correlation to clinical findings. We examined forty-eight patients with CIP.&nbsp;The Fatigue Severity Scale, Visual Analogue Scale for pain, Disability Rating Index, Berg Balance test and Medical Outcome Study 36-item short-form health status scale were correlated with clinical variables at long-term follow-up. Predominantly sensory symptoms and signs were found. Reduced balance and sensory function explained up to 31% of variance in self-reported physical impairment (p&nbsp;&lt; 0.0001). Otherwise, self-reported functioning and well-being could not be explained by clinical symptoms. Sensory deficits and balance problems are typical in CIP, and reduced balance and sensory functioning partially explained impaired physical functioning and well-being. Further follow-up could be indicated to investigate the effect of specific training programs and whether other factors may contribute to impaired functioning and well-being as well. &nbsp; Key words:&nbsp;Evaluation, functioning, polyneuropathy, well-being, outcome.

A pilot project of school-based intervention integrating drama and language awareness.

To help immigrant and refugee adolescents experiencing a severe academic delay cope with adversity, a school-based intervention combining drama workshops and language awareness activities was piloted in two classrooms. A qualitative analysis of participant observations was performed and the Strength and Difficulty Questionnaire and its Impairment Supplement was administered before and after the intervention. The observations were carried out in two Montreal high schools serving an underprivileged neighbourhood of immigrants, involving two classrooms of underschooled adolescents (n = 27) and two classes of similarly underschooled adolescents chosen among other teachers interested in the intervention, who accepted to participate as a comparison group (n = 28). The adolescents shared their experiences of adversity and felt empowered by the workshops. Self-reported impairment decreased in the intervention groups. The protective effect of creative language activities for immigrant and refugee youth should be further investigated.

Prevalence of Dual Sensory Impairment and Its Association With Traumatic Brain Injury and Blast Exposure in OEF/OIF Veterans

To describe the prevalence of self-reported rates of auditory, visual, and dual sensory impairment (DSI) in Afghanistan and Iraq war Veterans receiving traumatic brain injury (TBI) evaluations. Retrospective medical chart review. Thirty-six thousand nine hundred nineteen Veterans who received a TBI evaluation between October 2007 and June 2009. Final sample included 12,521 subjects judged to have deployment-related TBI and a comparison group of 9106 participants with no evidence of TBI. Self-reported auditory and visual impairment. Self-reported sensory impairment rates were: 34.6% for DSI, 31.3% for auditory impairment only, 9.9% for visual impairment only, and 24.2% for none/mild sensory impairment. Those with TBI and blast exposure had highest rate of DSI. Regression analyses showed that auditory impairment was the strongest predictor of visual impairment, and vice versa, suggesting these impairments may derive from a common source. Veterans who self-report clinically significant hearing or vision difficulty during routine TBI evaluation should be evaluated systematically and comprehensively to determine the extent of sensory impairment. Identifying DSI could allow clinicians to collaborate and maximize rehabilitation.

Functional Indications for Upper Eyelid Ptosis and Blepharoplasty Surgery: A Report by the American Academy of Ophthalmology

To evaluate the functional indications and outcomes for blepharoplasty and blepharoptosis repair by assessing functional preoperative impairment and surgical results. Literature searches of the PubMed and Cochrane Library databases were conducted on July 24, 2008, with no age or date restrictions, and they were limited to articles published in English. These searches retrieved 1147 citations; 87 studies were reviewed in full text, and 13 studies met inclusion criteria and were included in the evidence analysis. The 13 studies reported the functional effects or treatment results of simulated ptosis; several types of blepharoptosis repair, including conjunctiva-Müller's muscle resection, frontalis suspension, and external levator resection; and upper eyelid blepharoplasty. Repair of blepharoptosis and upper eyelid dermatochalasis provides significant improvement in vision, peripheral vision, and quality of life activities. Preoperative indicators of improvement include margin reflex distance 1 (MRD(1)) of 2 mm or less, superior visual field loss of at least 12 degrees or 24%, down-gaze ptosis impairing reading and other close-work activities, a chin-up backward head tilt due to visual axis obscuration, symptoms of discomfort or eye strain due to droopy lids, central visual interference due to upper eyelid position, and patient self-reported functional impairment. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Mirror Neuron Activity Associated with Social Impairments but not Age in Autism Spectrum Disorder

The neurobiology of autism spectrum disorder (ASD) is not particularly well understood, and biomedical treatment approaches are therefore extremely limited. A prominent explanatory model suggests that social-relating symptoms may arise from dysfunction within the mirror neuron system, while a recent neuroimaging study suggests that these impairments in ASD might reduce with age. Participants with autism spectrum disorder (i.e., DSM-IV autistic disorder or Asperger's disorder) (n = 34) and matched control subjects (n = 36) completed a transcranial magnetic stimulation study in which corticospinal excitability was assessed during the observation of hand gestures. Regression analyses revealed that the ASD group presented with significantly reduced corticospinal excitability during the observation of a transitive hand gesture (relative to observation of a static hand) (p < .05), which indicates reduced putative mirror neuron system activity within ventral premotor cortex/inferior frontal gyrus. Among the ASD group, there was also a negative association between putative mirror neuron activity and self-reported social-relating impairments, but there was no indication that mirror neuron impairments in ASD decrease with age. These data provide general support for the mirror neuron hypothesis of autism; researchers now must clarify the precise functional significance of mirror neurons to truly understand their role in the neuropathophysiology of ASD and to determine whether they should be used as targets for the treatment of ASD.

Self-Reported Vision Impairment and Its Contribution to Disability Among Older Adults

To examine contributions of self-reported vision impairment to disability by persons 65 years and older. We used data from the National Health and Nutrition Examination Survey (NHANES IV; 1999-2008; weighted N = 6,550). The four-staged Nagi model of the disability process, incorporating biomarkers, disease, and physical functioning, was used as a framework to guide variable selection. An unadjusted ordinal logistic regression model testing effects of vision on daily-life activities was compared with models that controlled covariates associated with each stage of the disability model. Where significant effects of poor vision remained, the strongest effect was found for doing leisure activities at home (OR = 5.29; 95% CI [3.14, 8.90]). Results suggest the importance of considering multiple health factors when formulating comprehensive vision rehabilitation interventions.

Geriatric Syndromes in Older Homeless Adults

The average age of the US homeless population is increasing. Little is known about the prevalence of geriatric syndromes in older homeless adults. To determine the prevalence of common geriatric syndromes in a sample of older homeless adults, and to compare these prevalences to those reported in the general older population. Cross-sectional. Two hundred and forty-seven homeless adults aged 50-69 recruited from eight homeless shelters in Boston, MA. Interviews and examinations for geriatric syndromes, including functional impairment, cognitive impairment, frailty, depression, hearing impairment, visual impairment, and urinary incontinence. The prevalences of these syndromes in the homeless cohort were compared to those reported in three population-based cohorts. The mean age of the homeless cohort was 56.0 years, and 19.8% were women. Thirty percent of subjects reported difficulty performing at least one activity of daily living, and 53.2% fell in the prior year. Cognitive impairment, defined as a Mini-Mental State Examination score <24, was present in 24.3% of participants; impaired executive function, defined as a Trail Making Test Part B duration >1.5 standard deviations above population-based norms, was present in 28.3% of participants. Sixteen percent of subjects met criteria for frailty, and 39.8% had major depression, defined as a score ≥10 on the Patient Health Questionnaire 9. Self-reported hearing and visual impairment was present among 29.7% and 30.0% of subjects, respectively. Urinary incontinence was reported by 49.8% of subjects. After multivariate adjustment for demographic characteristics, homeless adults were more likely to have functional impairment, frailty, depression, visual impairment and urinary incontinence compared to three population-based cohorts of older persons. Geriatric syndromes that are potentially amenable to treatment are common in older homeless adults, and are experienced at higher rates than in the general older population.

Factors contributing to impaired self-awareness of cognitive functioning in an HIV positive and at-risk population

Purpose: To examine the association between self-awareness of cognitive impairment and age, selected mood disorders, and type and severity of cognitive impairment in a sample of individuals with HIV/AIDS and at risk for HIV. Method: 75 subjects, 52 HIV+ and 23 at risk for HIV completed a psychosocial interview, the Patient’s Assessment of Own Functioning (PAOF) questionnaire, and a battery of neuropsychological tests. Based upon the differences between their clinical impairment and self-reported impairment, subjects were classified as being “Underestimators”, “Good Awareness”, or “Impaired Awareness” with regard to self-awareness. Results: Those with more severe cognitive impairment were less aware than those with normal or borderline cognitive impairment. A one-way ANOVA suggested that the Impaired Awareness group differed significantly from the Underestimators on the Rey Figure Immediate and Delayed Recall tasks, and from both the Underestimators and Good Awarenesss groups on the Digit Symbol Substitution Task. There were significant differences among all awareness groups on the test of Simple Reaction Time. Furthermore there is some suggestion that age may contribute to impaired self-awareness. The role of HIV in self-awareness remains unclear, as both, individuals with HIV and at risk, demonstrated impaired self-awareness. Conclusions: Overall, impaired awareness was associated with poorer test performance, suggesting a relationship between awareness and sustained complex attention and visual spatial processing. This research has implications for understanding factors contributing to poor awareness among individuals with cognitive impairment.Implications for RehabilitationImpaired self-awareness is associated with poor rehabilitation outcomes in populations with cognitive impairment.Individuals with and at risk for HIV/AIDS demonstrate cognitive impairments often associated with impaired self-awareness.Individuals with or at risk for HIV/AIDS have a critical need that could be addressed by rehabilitation professionals with expertise in assessing and treating impairments in self-awareness.

Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment—Is there a gender difference?

Background Vision and hearing decline with age. Loss of these senses is associated with increased risk of falls, injuries from falls, mortality and decreased health-related quality of life (HRQOL). Our objective was to determine if there are gender differences in the associations between visual and hearing impairment and these outcomes. Methods 2340 men and 3014 women aged 76–81 years from the Health in Men Study and the Australian Longitudinal Study on Women's Health were followed for an average of 6.36 years. Dependent variables were self-reported vision and hearing impairment. Outcome variables were falls, injuries from falls, physical and mental components of HRQOL (SF-36 PCS and MCS) and all-cause mortality. Results Vision impairment was more common in women and hearing impairment was more common in men. Vision impairment was associated with increased falls risk (odds ratio (OR) = 1.77, 95% CI = 1.35–2.32 in men; OR = 1.82, 95% CI = 1.44–2.30 in women), injuries from falls (OR = 1.69, 95% CI = 1.23–2.34 in men, OR = 1.79, 95% CI = 1.38–2.33 in women), and mortality (hazard ratio (HR) = 1.44; 95% CI = 1.17–1.77 in men; HR = 1.50, 95% CI = 1.24–1.82 in women) and declines in SF-36 PCS and MCS. Hearing impairment was associated with increased falls risk (OR = 1.38, 95% CI = 1.08–1.78 in men; OR = 1.45, 95% CI = 1.08–1.93 in women) and declines in SF-36 PCS and MCS. Overall there were no gender differences in the association between vision and hearing impairment and the outcomes. Conclusion In men and women aged 76–81 years, there were no gender differences in the association between self-reported vision and hearing impairment and the outcomes of falls, mortality and HRQOL.

The effects of adalimumab treatment and psoriasis severity on self-reported work productivity and activity impairment for patients with moderate to severe psoriasis

Psoriasis significantly impairs work productivity and daily activities. We sought to examine the effects of adalimumab on psoriasis-related work productivity and activity impairment and associations between the impairment and psoriasis severity in patients with moderate to severe psoriasis. Data were from the first 16 weeks of the Randomized controlled EValuation of adalimumab Every other week dosing in moderate to severe psoriasis TriAL (REVEAL). Outcomes as measured by the Work Productivity and Activity Impairment Questionnaire for Psoriasis (WPAI-Psoriasis) included employment status, total work productivity impairment, and total activity impairment. Logistic regression and analyses of covariance were used to assess the effects of adalimumab and treatment response (≥ 75% improvement in Psoriasis Area and Severity Index responders) on WPAI-Psoriasis outcomes. Longitudinal generalized estimating equations and Pearson correlation coefficients were used to assess associations between WPAI outcomes and psoriasis severity. Greater improvements in total work productivity impairment and total activity impairment were observed with adalimumab treatment versus placebo (15.5 and 11.1 percentage points, respectively; P < .001). Unemployment rate, total work productivity impairment, and total activity impairment were significantly associated with greater baseline psoriasis severity. Changes in WPAI outcomes were significantly correlated with greater psoriasis severity. The Dermatology Life Quality Index had stronger associations with changes in WPAI outcomes compared with clinical severity measures (Psoriasis Area and Severity Index and Physician Global Assessment). REVEAL only included WPAI data for 16 weeks. Therefore, long-term impact of adalimumab treatment on productivity outcomes could not be assessed. In addition, information on occupational job title or industry was not collected and data were not adjusted for psoriatic arthritis. Adalimumab reduced psoriasis-related work productivity and activity impairment in patients with moderate to severe psoriasis.

Predictors of posttraumatic stress-related impairment in victims of terrorism and ongoing conflict in Israel

The present study aimed to investigate the prevalence of self-reported impairment (Criterion F) as part of a probable DSM-IV diagnosis of posttraumatic stress disorder (PTSD) within a sample of 1001 Israeli Jews subjected to direct and indirect exposure to rocket attacks. Further, the present study aimed to investigate predictors of endorsing posttraumatic stress (PTS)-related impairment, with specific attention to the influence of resources and resource loss. Data were collected via phone surveys. Twenty-nine percent of the sample reported impairment; however, only 19% of those reporting impairment met criteria for probable PTSD. Logistic regression results indicated that psychosocial resource losses, experiencing personal injury or injury to a family member or close friend, experiencing other major life stressors in the past year, having poorer health, having significant sleep difficulty, and having traditional (moderate) religious practices, significantly predicted PTS-related impairment. Results suggest that addressing impairment only within the context of full PTSD misses many individuals experiencing significant PTS-related impairment.

Quantifying gait impairment in multiple sclerosis using GAITRite™ technology

This pilot study investigated the validity of the functional ambulatory profile (FAP) score from the GAITRite™ electronic pathway in persons with multiple sclerosis (PwMS) who had onset of walking impairment. Thirteen PwMS who had Expanded Disability Status Scale (EDSS) scores of 4.0–6.0 performed four trials on GAITRite™ pathway, and completed a multidimensional walking assessment including performance tests (timed 25 foot walk; T25FW, timed up and go; TUG), self reports of walking ability (Multiple Sclerosis Walking Scale-12; MSWS-12) and function (Late Life Function and Disability Inventory; LL-FDI), and free-living walking behavior (accelerometry). The FAP score correlated strongly with neurological disability (EDSS, ρ=−0.81), walking performance (T25FW, ρ=−0.82; TUG, ρ=−0.88) and self-reported walking function (LL-FDI, ρ=0.81), and moderately with self-reported walking impairment (MSWS-12, ρ=0.49) and free-living walking behavior (accelerometry, ρ=0.52). This suggests that the FAP score is a valid marker of gait impairment in PwMS who have onset of walking impairment.