Gait and cognitive impairments in multiple sclerosis: the specific contribution of falls and fear of falling

J Neural Transm (Vienna). 2017 Nov;124(11):1407-1416. doi: 10.1007/s00702-017-1765-0. Epub 2017 Jul 22.


Our goal was to identify the specific contribution of fear of falling (FoF) and falls with quantitative gait impairments and cognition capabilities in multiple sclerosis (MS) patients. Patients were separated into four individual subgroups as to the presence of FoF and falls (i.e., fearless/non-fallers, fearless/fallers, FoF/non-fallers and FoF/fallers). The Falls Efficacy Scale International questionnaire was used to assess the level of concern of falling. Participants were defined as "fallers" and "non-fallers" based on their fall history. Spatio-temporal parameters of gait were analyzed using an electronic mat. Cognitive performance was assessed by a computerized cognitive battery of tests. The study included 540 MS patients, 47% were defined as fallers and 61.9% reported a FoF. Non-significant differences were found between the fearless/non-fallers and fearless/fallers in all clinical, gait and cognitive scores. FoF/non-fallers walked significantly slower compared to fearless MS individuals who had previously fallen. Furthermore, the same patient group exhibited a poorer performance in the motor skills cognitive subdomain. A significant reverse relationship was found between FoF and cognitive motor skills in the fallers and non-fallers groups. FoF characterizes a more disabling symptom than falling in the MS population.

Keywords: Cognition; Falls; Fear of falling; Gait; Multiple sclerosis; Neurological.

MeSH terms

  • Accidental Falls* / statistics & numerical data
  • Adult
  • Cognition Disorders / etiology*
  • Fear / psychology*
  • Female
  • Gait Disorders, Neurologic / etiology*
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / psychology*
  • Neurologic Examination
  • Neuropsychological Tests
  • Retrospective Studies
  • Surveys and Questionnaires
  • Young Adult