Frailty and Falls in People Living With Multiple Sclerosis

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

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


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.

Original languageEnglish
Pages (from-to)952-957
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Issue number5
StatePublished - 1 May 2022
Externally publishedYes


  • Accidental falls
  • Aging
  • Frailty
  • Multiple sclerosis
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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