Anxiety Without Comorbid Depression Associated With Less Risk for Falls in MS

sad woman against brick wall
sad woman against brick wall
Investigators examined the involvement of depression and anxiety on cognition and falls in patients with multiple sclerosis.

Patients with multiple sclerosis (MS) who have anxiety without comorbid depression have a significantly lower risk for falling compared with other individuals with MS, according to results published in Multiple Sclerosis and Related Disorders.

In addition, the results indicated that patients with MS who have comorbid depression are significantly more likely to experience cognitive impairment than those without depression.

The study included patients with MS (N=122) who were divided into 4 subgroups according to their depression/anxiety status, as assessed by the Hospital Anxiety and Depression Scale: no depression/no anxiety, depression/no anxiety, no depression/anxiety, and depression/anxiety. The researchers evaluated participants’ cognitive performance using a computerized cognitive battery of tests. They defined participants as fallers or nonfallers based on fall histories elicited during a clinical interview.

A total of 31.1% (n=38) of participants had depression, 42.6% (n=52) had anxiety, and 45.9% (n=56) had neither depression nor anxiety.

Participants in the anxiety/no depression subgroup were 6 times less likely to experience a fall compared with those in the no depression/no anxiety group (odds ratio 0.160; 95% CI, 0.040-0.646; P =.010)

The researchers found significant differences in global cognitive scores for participants in the no anxiety/no depression group and the no anxiety/depression group (98.3 [standard deviation=9.6] vs. 90.5 [standard deviation=12.6], P =.037).

Participants in the depression/anxiety group were almost 4 times more likely to experience cognitive impairments compared with those in the no depression/no anxiety group. The prevalence of impaired cognition was highest in the anxiety/depression group (50.0%) and lowest in the no anxiety/no depression group (17.9%).

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“This study demonstrated the importance of considering combined and isolated anxiety and depression in [people with MS] and their relationship with cognition and falls,” the researchers wrote. “Future longitudinal investigations should evaluate if this phenotype of [people with] MS with anxiety and without depression fall less than with other mood groups.”


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.