Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement

Abstract

Background:The identification of the occurrence of falls is an important step for screening and for rehabilitation processes for the elderly. The methods of monitoring these events are susceptible to recording biases, and the choice of the most accurate method remains challenging. Objectives:(i) To investigate the agreement between retrospective self-reporting and prospective monitoring of methods of recording falls, and (ii) to compare the retrospective self-reporting of falls and the prospective monitoring of falls and recurrent falls over a 12-month period among older women at high risk of falls and fractures. Method:A total of 118 community-dwelling older women with low bone density were recruited. The incidence of falls was monitored prospectively in 116 older women (2 losses) via monthly phone calls over the course of a year. At the end of this monitoring period, the older women were asked about their recall of falls in the same 12-month period. The agreement between the two methods was analyzed, and the sensitivity and specificity of self-reported previous falls in relation to the prospective monitoring were calculated. Results:There was moderate agreement between the prospective monitoring and the retrospective self-reporting of falls in classifying fallers (Kappa=0.595) and recurrent fallers (Kappa=0.589). The limits of agreement were 0.35±1.66 falls. The self-reporting of prior falls had a 67.2% sensitivity and a 94.2% specificity in classifying fallers among older women and a 50% sensitivity and a 98.9% specificity in classifying recurrent fallers. Conclusion:Self-reporting of falls over a 12-month period underestimated 32.8% of falls and 50% of recurrent falls. The findings recommend caution if one is considering replacing monthly monitoring with annual retrospective questioning.

Falls prevention in community care: 10 years on

“… 11 Falls data that are collected retrospectively and based on recall have been shown to underestimate falls by ~20%. 34 , 35 Also, although the current and the 10 years prior survey achieved similar participant profiles on comparison data, many factors may have influenced differences between the two cohorts. Therefore, caution should be used in the interpretation of this comparative data.…”

Association between polypharmacy and falls in older adults: a longitudinal study from England

“…A study comparing retrospective self-report of falls with prospective records in older women from Brazil found moderate agreement (kappa=0.595) with sensitivity and specificity of 67.2% and 94.2%, respectively. 39 In comparison, a study comparing retrospective self-reports of falls with prospective calendar-reported method following a randomised controlled trial found 84% agreement between the two measures; however, the sensitivity was still 56%. 40 Information on confounders was extracted at wave 6, and changes in these covariates over the 2 years were not accounted for in the analysis.…”

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study

“…The main outcome of the study was incident falls, defined as "an event which results in a person coming to rest inadvertently on the ground or floor of other lower level" [ 24 ]. Over a 6-month period, participants tracked monthly fall incidence on fall calendars [ 25 , 26 ] and were contacted through monthly telephone calls [ 27 ]. In addition, we analyzed habitual gait speed, derived from the SPPB, at 6 months post baseline.…”