Epub ahead of print:
D'Orio et al. Cognitive and motor functioning in patients with multiple sclerosis: Neuropsychological predictors of walking speed and falls. J Neurol Sci. 2012 Feb 20.
While motor (power and coordination) and cognitive impairments (memory, calculations, time-keeping, problem solving) are common in MS'ers, research concerning their relationship is limited. These investigators aimed to evaluate associations between cognitive function, walking speed, and falls in MS'ers. They reviewed 81 MS'ers who had had measures of cognitive function, predicted walking speed on the Timed 25-Foot Walk and self-reported fall frequency documented. After controlling for age, gender, and disease severity, slower processing speed and IQ predicted slower walking speed, while poorer verbal memory predicted increased frequency of falls. Poorer verbal memory also predicted increased risk of multiple falls. Thus, specific cognitive functions are related to mobility limitations in MS'ers. These findings suggest that risk assessment for gait decline and falls should include cognitive assessment.
"Whether reduced walking speed and falls are causally related to cognitive impairment will require further study. They may simply be associated with each other due to the severity of MS. The bottom line is that MS is bad disease and that dysfunction in multiple neurological systems occur together. In my experience cognitive impairment is often associated with reduced insight into other disabilities; this makes simple fall prevention strategies that are often based on education and behavioural therapy difficult to implement successfully."
"This is study is that great in that it was retrospective and involved a chart review. In other words it was an audit of pre-existing data. These kinds of studies are best done if the are prospective and pre-planned using a strict and well thought-out protocol. Nevertheless the study highlights the problems of co-disabilities that many MS'ers have to deal with. Preventing disability should be our priority."
Labels: cognition, disability, falls