Does cognitive performance explain the gap between physiological and perceived fall-risk in people with multiple sclerosis?

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY Multiple sclerosis and related disorders Pub Date : 2025-03-01 Epub Date: 2025-02-05 DOI:10.1016/j.msard.2025.106322

Tobia Zanotto , Danya Pradeep Kumar , Daniel Golan , Jeffrey Wilken , Glen M Doniger , Myassar Zarif , Barbara Bumstead , Marijean Buhse , Joanna Weller , Sarah A Morrow , Iris-Katharina Penner , Laura Hancock , Thomas J Covey , Edward Ofori , Daniel S Peterson , Robert W Motl , Hans Bogaardt , Marissa Barrera , Riley Bove , Herbert Karpatkin , Mark Gudesblatt

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Abstract

Background

Cognitive impairment is linked with increased risk of falls in people with multiple sclerosis (pwMS), but it is not clear whether cognitive performance may help to account for the discordance between fall-risk due to actual physiological functioning and the individual's perception of their fall-risk. This study examined the relationship between cognitive performance and the concordance/discordance of physiological and perceived fall-risk in pwMS.

Methods

: In this single-center cross-sectional analysis of 201 pwMS, proxies for physiological (gait speed) and perceived (Modified Falls Efficacy Scale) fall-risk were collected. Participants were categorized into 4 groups using established cut-off values: high physiological – high perceived (H_phy-H_per), high physiological – low perceived (H_phy-L_per), low physiological – low perceived (L_phy-L_per), and low physiological – high perceived (L_phy-H_per) fall-risk. Cognitive performance was evaluated using the NeuroTrax computerized cognitive battery, which generates a global cognitive score (GCS) as well as scores for individual cognitive domains.

Results

Overall, 27.4 % of participants exhibited a discordance between physiological and perceived fall-risk. Individuals with discordant fall-risk did not have worse cognitive scores than individuals with concordant fall-risk, whether GCS or individual cognitive domains. However, among concordant groups, participants in the H_phy-H_per group had worse cognitive scores (GCS) as well as information processing, attention, motor skills, executive function and visual spatial domain scores than participants in the L_phy-L_per group.

Conclusion

In this study, one in 4 pwMS had a discordance between their physiological and perceived fall-risk. This discordance was not explained by cognitive performance.

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认知表现能否解释多发性硬化症患者的生理和感知跌倒风险之间的差距？

认知障碍与多发性硬化症（pwMS）患者跌倒风险增加有关，但目前尚不清楚认知表现是否有助于解释实际生理功能导致的跌倒风险与个人对跌倒风险的感知之间的不一致。本研究探讨了认知表现与脑卒中患者生理跌倒风险和知觉跌倒风险的一致性/不一致性之间的关系。方法：对201例pwMS进行单中心横断面分析，收集生理（步态速度）和感知（改良跌倒功效量表）跌倒风险指标。参与者根据既定的临界值分为4组：高生理-高感知（Hphy-Hper）、高生理-低感知（Hphy-Lper）、低生理-低感知（Lphy-Lper）和低生理-高感知（Lphy-Hper）跌倒风险。认知表现使用NeuroTrax计算机化认知电池进行评估，该电池产生整体认知评分（GCS）以及个人认知领域评分。结果总体而言，27.4%的参与者表现出生理和感知跌倒风险之间的不一致。无论是GCS还是个体认知领域，不一致跌倒风险个体的认知得分并不比一致跌倒风险个体差。然而，在和谐组中，Hphy-Hper组的参与者在认知得分（GCS）以及信息处理、注意力、运动技能、执行功能和视觉空间领域得分上都比Lphy-Lper组的参与者差。结论在本研究中，1 / 4的pwMS患者的生理跌倒风险与感知跌倒风险不一致。这种不一致不能用认知表现来解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.