Social participation and self-reported physical, cognitive, and fall-related outcomes in persons with multiple sclerosis

Background: The relationship between social participation and health-related outcomes remains underexplored among individuals with multiple sclerosis (MS). This study aimed to examine associations between social participation and self-reported outcomes, and to explore whether these relationships varied by age and sex. Methods: A total of 1162 adults with MS (mean age: 52.3 years, 80.6% female) completed an online survey. Social participation was assessed using the short form of the ability to participate in social roles and activities of the Quality of Life in Neurological Disorders. Outcomes included self-reported ambulation difficulty (Multiple Sclerosis Walking Scale-12), cognitive deficit (Perceived Deficits Questionnaire), fatigue (Modified Fatigue Impact Scale), dual-task difficulty (Dual-Task Impact on Daily Living Questionnaire), fear of falling (Fall Efficacy Scale-International), and recurrent falls (>1 fall). Linear and logistic regression models were used to examine the associations between social participation and self-reported outcomes. Results: Greater social participation is associated with reduced fatigue (B [95% CI] = -2.04 [-2.38, -1.70]), ambulation difficulty (-1.79 [-2.19, -1.38]), cognitive deficit (-0.40 [-0.50, -0.30]), dual-task difficulty (-1.30 [-1.59, -1.01]), fear of falling (-0.75 [-0.91, -0.60]), and recurrent falls (OR [95% CI] = 0.89 [0.83, 0.95]). Significant age and social participation interactions were observed for cognition, ambulation, and fatigue, with older adults showing smaller magnitudes of benefits from social participation. Only cognition showed significant sex and social participation interaction, with a stronger association among females than males with MS. Conclusions: This study supports the clinical relevance of social participation as a factor associated with health-related outcomes in people with MS.