title: Medications Are Associated with Falls in People with Multiple Sclerosis: A Prospective Cohort Study.
abstract: BACKGROUND
  Medication use is associated with falls in many populations, but the relationship between medications and falls in people with multiple sclerosis (MS) is not well understood.
  
  
  METHODS
  The number and types of medications used by 248 ambulatory adults with MS in the United States (n = 53) and Australia (n = 195) were assessed. Participants completed fall diaries for 6 months. Associations between number and type of medications reported and falls, adjusting for age, disease severity, comorbidities, sex, and country, were evaluated using multiple logistic regression.
  
  
  RESULTS
  Participants reported taking a median of three medications and two supplements. A total of 143 participants (58%) fell at least once in the 6 months, and 110 (44%) experienced one or more injurious falls. The adjusted relative odds of a fall or an injurious fall increased by 13% (P = .048) and 11% (P = .049), respectively, for each medication and by 43% (P = .015) and 55% (P = .001) for each neurologically active medication. Reported use of MS disease-modifying therapy was associated with 48% decreased odds of falling (P = .035) but not significantly decreased odds of injurious falls.
  
  
  CONCLUSIONS
  Reporting use of more medications and more neurologically active medications is associated with falls and injurious falls in people with MS. Close evaluation of the need for each medication, with associated minimization of neurologically active medications in patients with MS, may help prevent falls. Use of MS disease-modifying therapies may be associated with fewer falls. This relationship needs further evaluation.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR, USA (MHC, LK, DB); Neuroscience Research Australia, University of New South Wales, Sydney, Australia (PH, SL); and Veterans Affairs Portland Health Care Services, Portland, OR, USA (MHC, DB).
authors.forename: Michelle H
authors.initials: MH
authors.lastname: Cameron
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR, USA (MHC, LK, DB); Neuroscience Research Australia, University of New South Wales, Sydney, Australia (PH, SL); and Veterans Affairs Portland Health Care Services, Portland, OR, USA (MHC, DB).
authors.forename: Lisa
authors.initials: L
authors.lastname: Karstens
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR, USA (MHC, LK, DB); Neuroscience Research Australia, University of New South Wales, Sydney, Australia (PH, SL); and Veterans Affairs Portland Health Care Services, Portland, OR, USA (MHC, DB).
authors.forename: Phu
authors.initials: P
authors.lastname: Hoang
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR, USA (MHC, LK, DB); Neuroscience Research Australia, University of New South Wales, Sydney, Australia (PH, SL); and Veterans Affairs Portland Health Care Services, Portland, OR, USA (MHC, DB).
authors.forename: Dennis
authors.initials: D
authors.lastname: Bourdette
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, OR, USA (MHC, LK, DB); Neuroscience Research Australia, University of New South Wales, Sydney, Australia (PH, SL); and Veterans Affairs Portland Health Care Services, Portland, OR, USA (MHC, DB).
authors.forename: Stephen
authors.initials: S
authors.lastname: Lord