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
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.
Arch Phys Med Rehabil. 2022 May;103(5):952-957. doi: 10.1016/j.apmr.2021.10.025. Epub 2021 Nov 24.
To explore the association between frailty and history of falls in people living with multiple sclerosis (MS).
Secondary analysis.
University research laboratories in the United States and Israel.
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.
Not applicable.
A frailty index was calculated from 40 health deficits by following standard validated procedures. The number of falls (12-month history) was recorded.
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).
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.
探讨多发性硬化症（MS）患者的虚弱与跌倒史之间的关联。
二次分析。
美国和以色列的大学研究实验室。
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）。
不适用。
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）。
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）。
本研究确定了MS患者的虚弱与跌倒史之间存在显著关系，且独立于年龄、性别和疾病严重程度。这些发现支持了虚弱是一种与MS中的残疾相关但独立于残疾的综合征这一观点。
