Accuracy of clinical-functional tools to identify risk of falls among community-dwelling older adults

Abstract

Introduction: The identification of older adults who present greater chances of falling is the first step in the prevention of falls. Clinical instruments have been shown to be able to differentiate fallers from non-fallers, but their predictive validity remains controversial. Objective: To investigate the accuracy of the Short Physical Performance Battery (SPPB) and Quick Screen Clinical Fall Risk Assessment (QuickScreen) instruments to identify risk of falls in community-dwelling older adults. Method: This is a prospective methodological study with 81 older adults (≥ 60 years), assessed at baseline by SPPB and QuickScreen and monitored after one year to identify the occurrence of falls. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the ROC curve (AUC) were calculated. Results: 28.4% of the sample reported falls. QuickScreen presented 52.2% sensitivity, 74.1% specificity, 44.4% PPV, 79.6% NPV and 0.656 AUC. The AUC for SPPB was not significant (p = 0.087). Conclusion: QuickScreen presented poor accuracy when predicting falls and SPPB was unable to identify community-dwelling older adults at risk of falls. The QuickScreen instrument stood out for its high potential to identify true negatives.

Psychometric Properties of the European Portuguese Version of the Memorial Emergency Department Fall Risk Assessment Tool

“…A fall is defined as an involuntary and incorrigible displacement from an individual’s initial position to a lower level, resulting from the complex interaction of multifactorial circumstances, which may be intrinsic, extrinsic, behavioral, and environmental [ 8 ]. Falls are considered a public health issue worldwide, and, in hospitals, they are responsible for two out of every five adverse events related to patient care [ 9 , 10 ].…”