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The relationship between depression, anxiety and cognition and its paradoxical impact on falls in multiple sclerosis patients.
Mult Scler Relat Disord 2018; 25:167-172MS

Abstract

Although falls, cognitive impairments and mood disorders are very common in people with MS (PwMS) the relationship between these conditions has received scant attention. Therefore, the purpose of the study was to investigate the specific involvement of depression and anxiety on cognition and falls in PwMS. The study included 122 PwMS (75 women) divided into four subgroups according to their manifestation of depression and anxiety assessed by the Hospital Anxiety and Depression Scale (HADS) (i.e. no depression/no anxiety, depression/no anxiety, no depression/anxiety and depression/anxiety). Cognitive performance was evaluated via a computerized cognitive battery of tests. Participants were defined as "fallers" and "non-fallers" based on their fall history recorded during a clinical interview. Thirty-eight PwMS (31.1%) were classified as depressed (mean HADS 11.1, SD = 3.4); 52 (42.6%) were classified as anxious (mean HADS 11.1, S.D = 3.1) and 56 (45.9%) were neither depressed nor anxious. PwMS categorized in the anxiety/non-depressed subgroup were 6 times less likely to fall than PwMS without depression or anxiety (OR = 0.160, 95%CI = 0.040-0.646; P-value = 0.010). In terms of global cognitive status, depressed PwMS with anxiety were almost 4 times more likely to experience cognitive impairments compared to PwMS who were not depressed or anxious. Anxiety without comorbid depression is associated with less risk of falling, even when comparing MS patients without depression or anxiety. Future longitudinal investigations should confirm if this phenotype of MS patients with anxiety and without depression fall less compared with other mood groups.

Authors+Show Affiliations

Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: alonkalr@post.tau.ac.il.Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer Street, Tel Hashomer, Israel. Electronic address: roy.aloni@sheba.health.gov.il.Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: Gilles.Allali@hcuge.ch.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30086536

Citation

Kalron, Alon, et al. "The Relationship Between Depression, Anxiety and Cognition and Its Paradoxical Impact On Falls in Multiple Sclerosis Patients." Multiple Sclerosis and Related Disorders, vol. 25, 2018, pp. 167-172.
Kalron A, Aloni R, Allali G. The relationship between depression, anxiety and cognition and its paradoxical impact on falls in multiple sclerosis patients. Mult Scler Relat Disord. 2018;25:167-172.
Kalron, A., Aloni, R., & Allali, G. (2018). The relationship between depression, anxiety and cognition and its paradoxical impact on falls in multiple sclerosis patients. Multiple Sclerosis and Related Disorders, 25, pp. 167-172. doi:10.1016/j.msard.2018.07.029.
Kalron A, Aloni R, Allali G. The Relationship Between Depression, Anxiety and Cognition and Its Paradoxical Impact On Falls in Multiple Sclerosis Patients. Mult Scler Relat Disord. 2018;25:167-172. PubMed PMID: 30086536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship between depression, anxiety and cognition and its paradoxical impact on falls in multiple sclerosis patients. AU - Kalron,Alon, AU - Aloni,Roy, AU - Allali,Gilles, Y1 - 2018/07/27/ PY - 2017/12/05/received PY - 2018/06/18/revised PY - 2018/07/16/accepted PY - 2018/8/8/pubmed PY - 2018/12/19/medline PY - 2018/8/8/entrez KW - Anxiety KW - Cognition KW - Depression KW - Falls KW - Multiple sclerosis SP - 167 EP - 172 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 25 N2 - Although falls, cognitive impairments and mood disorders are very common in people with MS (PwMS) the relationship between these conditions has received scant attention. Therefore, the purpose of the study was to investigate the specific involvement of depression and anxiety on cognition and falls in PwMS. The study included 122 PwMS (75 women) divided into four subgroups according to their manifestation of depression and anxiety assessed by the Hospital Anxiety and Depression Scale (HADS) (i.e. no depression/no anxiety, depression/no anxiety, no depression/anxiety and depression/anxiety). Cognitive performance was evaluated via a computerized cognitive battery of tests. Participants were defined as "fallers" and "non-fallers" based on their fall history recorded during a clinical interview. Thirty-eight PwMS (31.1%) were classified as depressed (mean HADS 11.1, SD = 3.4); 52 (42.6%) were classified as anxious (mean HADS 11.1, S.D = 3.1) and 56 (45.9%) were neither depressed nor anxious. PwMS categorized in the anxiety/non-depressed subgroup were 6 times less likely to fall than PwMS without depression or anxiety (OR = 0.160, 95%CI = 0.040-0.646; P-value = 0.010). In terms of global cognitive status, depressed PwMS with anxiety were almost 4 times more likely to experience cognitive impairments compared to PwMS who were not depressed or anxious. Anxiety without comorbid depression is associated with less risk of falling, even when comparing MS patients without depression or anxiety. Future longitudinal investigations should confirm if this phenotype of MS patients with anxiety and without depression fall less compared with other mood groups. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/30086536/The_relationship_between_depression_anxiety_and_cognition_and_its_paradoxical_impact_on_falls_in_multiple_sclerosis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(18)30240-2 DB - PRIME DP - Unbound Medicine ER -