More than 50% of people with MS experience falls. Falls can cause injuries that can require medical attention and also significantly impact on quality of life and independence for people with MS.

Many of the symptoms of MS can contribute to the risk of falling, including poor coordination, sensory changes, reduced muscle strength and changes to thinking processes.

MS Research Australia-funded researchers Dr Phu Hoang and Professor Stephen Lord, from Neuroscience Research Australia (NeuRA), have been investigating the factors that put people with MS at greater risk of falling, with the aim of developing targeted interventions to reduce the risk of falling. Dr Hoang is also a practicing physiotherapist with MS-ACT/NSW/VIC.

Together with their US colleagues at the Oregon Health and Science University, they have just published some of the findings from their study, showing that the more non-MS prescription medications a person is using, the greater the risk of falling.

While the team showed that immune-modifying treatments for MS do reduce the risk of falling, the use of multiple other medications, particularly those that act on the brain and nervous system such as anti-depressants, can increase the risk of falls.

Professor Lord and Dr Hoang were awarded an MS Research Australia project grant in 2012 to investigate the risk factors for falls in people with MS. Their work has led to many insights into falls risk in people with MS and has also led to the development of a falls prevention strategy which is now being tested in a clinical trial, also supported by MS Research Australia.

Other researchers have previously shown in aged populations that the use of multiple medications, particularly those that act on the brain and nervous system, is associated with increased falls risk.

However, this is the first time that this association has been investigated in detail in people with MS. The team used falls diaries, completed over a six month period, by 53 Americans with MS and 195 Australians with MS, and they also collected information on the participants’ use of prescription medications and dietary supplements.
The research, now published in the International Journal of MS Care, shows that as with the aged population, the risk of falling in people with MS increases significantly with each additional medication used.

Medications that act on the brain and nervous system, particularly those used for depression, showed a strong connection with falls risk even when the level of disability and disease severity was taken into account. Other medications that target the digestive system and metabolism, were also connected with an increased risk of falling.

Immune-modifying medications used to treat MS, encouragingly, were shown to reduce the risk of falling. Dietary supplements were not associated with any change in falls risk.

Further research is needed to confirm their findings and investigate the detailed reasons for this association. However, the researchers suggest that health care professionals should be vigilant in discussing the need for each medication with people with MS, to ensure the right balance is reached between managing the complex range of symptoms experienced by people with MS as well as reducing the risk of falls.