Author Of 1 Presentation
P0716 - Fall frequency and risk factors in patients with neuromyelitis optica spectrum disorder (ID 547)
Abstract
Background
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune chronic disease in the central nervous system (CNS). Some symptoms of NMOSD such as vision loss, sensory loss, weakness, pain, bladder and bowel incontinence, and spasm are in constant with fall risk factors that have been established in general population and other neurological diseases. So, we hypothesized that the frequency of fall in NMOSD patients could be higher than general population.
Objectives
Evaluation of falls frequency and its risk factors in patients with neuromyelistis optica spectrum disorder, and compared to healthy individuals
Methods
Ninety-five NMOSD patients and 100 healthy controls (HC) participated in this cross-sectional study. Participants self-reported fall history including number of falls, rate and type of injury over the last six months. Individual with two or more falls was considered as faller. Subjects were assessed with questionnaires for severity of pain (brief pain inventory) and fatigue (fatigue severity score), and were examined for severity of disease (Expanded Disability Status Scale [EDSS]), cognition function (mini-mental state examination), and balance (berg balance score). We also obtained demographic and other clinical information including age, sex, education level, body mass index (BMI), disease duration, and brain MRI findings.
Results
A total of 58 (61.1%) NMOSD patients and 35 (35.0%) healthy individuals reported at least one fall, with 33 (34.7%) of NMOSD and 15 (15.0%) of healthy participants had two or more falls. The risk to being a faller in NMOSD was significantly higher than HC (adjusted OR=2.497; 95%CI: 1.218, 5.120; p=0.013). On univariate model, EDSS score, disease duration, fatigue severity, pain score, and berg balance score were risk factors for falling. On multivariate model, EDSS score (OR=14.41; 95%CI: 2.108, 98.56; p=0.007), pain severity score (OR=2.646; 95%CI: 1.224, 5.719; p=0.013), and severity of fatigue (OR=1.170; 95%CI: 1.027, 1.332; p=0.018) had association with fall in NMOSD patients. Model performance was further assessed using analysis of the ROC curve. The area under the curve was 0.975 (95% CI: 0.947, 1.000). Using Youden index, the optimal cut-off value of the model was determined to be 0.3439, with sensitivity and specificity at this point being 0.880 (95% CI: 0.687, 0.974) and 0.951 (95% CI: 0.863, 0.989), respectively.
Conclusions
Our findings suggested that NMOSD is a risk factor for falling. Further longitudinal study is needed to fully understand the implications of fall in NMOSD.