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Meta-Analysis
. 2015 Jan;21(1):92-100.
doi: 10.1177/1352458514538884. Epub 2014 Jun 16.

Falls in people with MS--an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States

Y Nilsagård  1 , H Gunn  2 , J Freeman  2 , P Hoang  3 , S Lord  3 , Rajarshi Mazumder  4 , Michelle Cameron  5
Affiliations
Meta-Analysis

Falls in people with MS--an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States

Y Nilsagård et al. Mult Scler. 2015 Jan.

Abstract

Background: Falls are common in people with multiple sclerosis (PwMS). Previous studies have generally included small samples and had varied methods.

Objectives: The objectives of this paper are to compile fall rates across a broad range of ages and disease severity and to definitively assess the extent to which MS-associated and demographic factors influence fall rates.

Methods: Individual data from studies in four countries that prospectively measured falls for three months were analyzed. We determined fall rates, prevalence of fallers (≥1 falls) and frequent fallers (≥2 falls), location and timing of falls, and fall-related demographic factors.

Results: A total of 537 participants reported 1721 falls: 56% were fallers and 37% frequent fallers. Most falls occurred indoors (65%) between 6 a.m. and 6 p.m. (75%). Primary progressive MS was associated with significantly increased odds of being a faller (odds ratio (OR) 2.02; CI 1.08-3.78). Fall risk peaked at EDSS levels of 4.0 and 6.0 with significant ORs between 5.30 (2.23-12.64) and 5.10 (2.08-12.47). The fall rate was lower in women than men (relative risk (RR) 0.80; CI 0.67-0.94) and decreased with increasing age (RR 0.97 for each year, CI 0.95-0.98).

Conclusion: PwMS are at high risk of falls and there are important associations between falls and MS-associated disability, gender and age.

Keywords: Accidental falls; cohort studies; meta-analysis; multiple sclerosis; risk factors.

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Conflict of interest statement

Conflicts of interest: None declared.

Figures

Figure 1.
Figure 1.
Association between EDSS and risk of being classified as a faller (≥1 fall, unadjusted OR). EDSS: Expanded Disability Status Scale; OR: odds ratio.
See this image and copyright information in PMC

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