Associations between bladder dysfunction and falls in people with relapsing-remitting multiple sclerosis

Background: Bladder dysfunction and falls are common in people with multiple sclerosis (MS), but associations between these problems are unclear. We sought to clarify the association between specific types of bladder dysfunction and prospectively recorded falls in people with MS. Methods: Fifty-one people aged 18 to 50 years with relapsing-remitting MS and mild-to-moderate disability (Expanded Disability Status Scale score ≤6.0) completed a self-report questionnaire regarding urinary incontinence, urgency, and frequency at baseline and then prospectively recorded their falls daily for 3 months using fall calendars. Participants were classified as recurrent fallers (two or more falls) or nonrecurrent fallers (fewer than 2 falls) for one regression model and then as fallers (one or more falls) or nonfallers (no falls) for another regression model. Associations between baseline bladder dysfunction and faller status were assessed using logistic regression adjusted for the potential confounders of age, sex, and disability. Results: Fifteen participants were recurrent fallers, 36 were nonrecurrent fallers, 32 were fallers, and 19 were nonfallers. After adjusting for age, sex, and disability, there was a significant association between urinary urgency with incontinence and recurrent falls in the 3 months after baseline (odds ratio, 57.57; 95% CI, 3.43-966.05; P = .005). Conclusions: Urinary urgency with incontinence is associated with recurrent falls in people with relapsingremitting MS with mild-to-moderate disability. Further research is needed to better understand the mechanisms underlying this association and to evaluate the effect of bladder management programs on falls.