Frailty in people with multiple sclerosis who use wheelchairs or scooters

Research Objectives: To evaluate frailty through the deficit accumulation model and to explore the relationship of frailty with multiple sclerosis (MS) clinical subtypes, disease duration and fall-history in people with MS who use wheelchairs or scooters.

Design: Secondary analysis of baseline data collected as part of a multi-center non-randomized clinical trial focusing on a personalized fall prevention intervention.

Setting: University research laboratories in the United States.

Participants: Forty-five people with MS who use wheelchairs or scooters (median age=60.0 [16.0] years, 82.2% female, patient determined disease steps score=7.0).

Interventions: Not applicable.

Main Outcome Measures: A frailty index was calculated by following standard validated procedures. Information on demographics, MS clinical subtypes, disease duration, and six-month fall-history were collected as part of a standardized medical survey.

Results: The mean frailty index score was 0.54 (SD=0.13). Overall, 91.1% and 8.9% of participants met objective diagnostic criteria for severe and moderate frailty, respectively. A one-way ANOVA revealed no significant differences (F=0.054, p=0.948) in the frailty index among participants with relapsing-remitting MS, primary progressive, and secondary progressive MS. No relationship between frailty and disease duration (r=-0.058, p=0.706) was found. A univariable negative binomial regression analysis revealed a significant association between frailty index scores and the number of falls experienced in the previous six months (IRR=1.75, 95% CI [1.06-2.91], p=0.030).

Conclusions: The current study suggests that individuals with MS with advanced disability also live with coexisting frailty. The significant overlap observed between severe disability and severe frailty highlights the emerging need to untangle this bi-directional relationship to identify appropriate therapeutic pathways in the MS population living with advanced disability.

Author(s) Disclosures: Nothing to disclose.