Cognitive and motor slowing mediate the relationship between depression and falls in multiple sclerosis patients.

Objective: Given the limited research concerning the relationship between depression and falls in multiple sclerosis (MS), this study aimed to examine the direct and indirect association between fall history and depressive symptoms. Methods: One hundred and forty seven MS patients had completed at least one neuropsychological assessment that included detailed information regarding fall history, as well as measures of depression, motor function, and cognitive processing speed. Results: Fall history was associated with higher depressive symptoms and poorer overall motor function. Higher self-reported depressive symptoms were associated with higher odds of falls in the last year (OR = 1.64, 95% CI 1.16, 2.31) in an age adjusted model. Cognitive and motor slowing serially mediated the relationship between depressive symptoms and fall history (estimate = 0.060, 95% CI = 0.01, 0.15). Conclusions: With the extensive research on the cognitive and motor correlates of falls in MS, our findings suggest that depressive symptoms are also associated with falls in people with MS. Moreover, this study provides preliminary support for a pathway by which depressive symptoms are related to falls in part through their relationships with cognitive and motor slowing.