The association of self-reported dual-task ability with fear of falling and recurrent falls in individuals with multiple sclerosis.

Abstract

To determine the association of self-reported dual-task ability with fear of falling and recurrent falls in individuals with multiple sclerosis (MS). Cross-sectional study. Individuals with MS were recruited from the general community in the US. A total of 1,083 people with MS were enrolled. The sample was predominantly female (80.52%). Of the total, 262 participants (24.19%) were classified as recurrent fallers. Patient-Determined Disease Steps (PDDS) scores ranged from 0 to 6, with 563 participants (52.00%) reporting mild disability (PDDS = 0-2). Not applicable. A dual-task impact on daily life activities questionnaire (DIDA-Q) and its subdomains of motor-motor interference (MMI) and cognitive-motor interference (CMI) were assessed. The total, MMI, and CMI scores were expressed in a 5-point interval scale for ease of interpretation. The total score of the fall efficacy scale-international (FES-I) was dichotomized into low and high fear of falling based on a cut-off score of 35.5. Fall status was categorized as non- or single fall (≤ 1 fall) and recurrent falls (>1 fall) within the past three months. Every 5-point increase in the DIDA-Q was significantly associated with fear of falling (Odds ratio [OR]: 1.71, 95% CI: 1.56-2.88), as were the CMI (OR: 2.05, 95% CI: 1.80-2.34) and MMI (OR: 3.48, 95% CI: 2.80-4.34). The DIDA-Q total score (OR: 1.14, 95% CI: 1.07-1.21), CMI (OR: 1.19, 95% CI: 1.09-1.29), and MMI (OR: 1.42, 95% CI: 1.21-1.66) were significantly associated with increased likelihood of recurrent falls. The study indicates that self-reported dual-task difficulty was associated with fear of falling and recurrent falls in persons with MS. Considering that current in-lab dual-task assessments are insufficient to predict falls, the self-reported dual-task questionnaire can be an effective alternative for screening fall risk in this population.