多发性硬化症患者的衰弱与跌倒

Frailty and Falls in People Living With Multiple Sclerosis.

作者信息

Zanotto Tobia, Galperin Irina, Mirelman Anat, Yehezkiyahu Shahar, Estes John, Chen Lingjun, Regev Keren, Karni Arnon, Schmitz-Hübsch Tanja, Paul Friedemann, Lynch Sharon G, Akinwuntan Abiodun E, Devos Hannes, Hausdorff Jeffrey M, Sosnoff Jacob J

机构信息

Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS; Illinois Multiple Sclerosis Research Collaborative, Interdisciplinary Health Science Institute, University of Illinois at Urbana-Champaign, Urbana, IL.

Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

出版信息

Arch Phys Med Rehabil. 2022 May;103(5):952-957. doi: 10.1016/j.apmr.2021.10.025. Epub 2021 Nov 24.

DOI:10.1016/j.apmr.2021.10.025

PMID:34838587

Abstract

OBJECTIVE

To explore the association between frailty and history of falls in people living with multiple sclerosis (MS).

DESIGN

Secondary analysis.

SETTING

University research laboratories in the United States and Israel.

PARTICIPANTS

A total of 118 people (N=118) with relapsing-remitting MS (mean age, 48.9±10.0 years; 74.6% female; Expanded Disability Status Scale [EDSS] range, 1.0-6.0) were studied in this cross-sectional analysis.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

A frailty index was calculated from 40 health deficits by following standard validated procedures. The number of falls (12-month history) was recorded.

RESULTS

Overall, 33.9%, 29.7%, and 36.4% of participants were classified as nonfrail, moderately frail, and severely frail, respectively. The frailty index was significantly correlated (ρ=0.37, P<.001) with higher scores on the EDSS. In univariable negative binomial regression analysis, the frailty index was associated with a higher number of falls (incidence rate ratio [IRR]=3.33; 95% CI, 1.85-5.99; P<.001). After adjustment for age, sex, and EDSS, frailty remained strongly associated with history of falls (IRR=2.78; 95% CI, 1.51-5.10; P=.001).

CONCLUSIONS

The current study identifies a significant relationship between frailty and history of falls in MS, independent of age, sex, and disease severity. These findings support the notion that frailty is a syndrome related to but independent of disability in MS.

摘要

目的

探讨多发性硬化症（MS）患者的虚弱与跌倒史之间的关联。

设计

二次分析。

地点

美国和以色列的大学研究实验室。

参与者

本横断面分析共纳入118例复发缓解型MS患者（平均年龄48.9±10.0岁；74.6%为女性；扩展残疾状态量表[EDSS]范围为1.0 - 6.0）。

干预措施

不适用。

主要观察指标

按照标准验证程序，根据40项健康缺陷计算虚弱指数。记录跌倒次数（12个月内的跌倒史）。

结果

总体而言，分别有33.9%、29.7%和36.4%的参与者被分类为非虚弱、中度虚弱和重度虚弱。虚弱指数与EDSS得分较高显著相关（ρ = 0.37，P <.001）。在单变量负二项回归分析中，虚弱指数与跌倒次数较多相关（发病率比[IRR]=3.33；95%置信区间，1.85 - 5.99；P <.001）。在对年龄、性别和EDSS进行调整后，虚弱与跌倒史仍密切相关（IRR = 2.78；95%置信区间，1.51 - 5.10；P =.001）。