Falls risk assessment score (FRAS): Time to rethink

Abstract

a b s t r a c tBackground: Early in the development of geriatric medicine, falls were identified as a "geriatric giant", a nonspecific indicator of functional decompensation. This led to the notion of "falls prevention services", and the concept that identification of those patients at high risk of falls is essential to approach this group of elderly people. Objective: This work was carried out aiming to develop a model that predicts falls risk for both in-as well as outpatients using clinical variables that are easily assessed in clinical practice. Study Design: A case-control study to determine the risk factors and the prediction rule of falls risk among older people. Methods: Three hundred and seventy-three outpatients and 186 inpatients, with a minimum age of 65 years, were assessed for falls risk factors. The clinical characteristics with independent predictive value for the development of falls were selected using logistic regression analysis. The diagnostic performance of the prediction rule was evaluated using the area under the curve. Cross-validation controlled for over fitting of the data (internal validation) was also carried out. Results: The prediction rule consisted of five clinical variables: history of falls in the last 12 months, slowing of the walking speed/change in gait, history of loss of balance in the last 12 months, and impaired sight and weak hand grip. The prediction score ranged from 0 to 6.5, and corresponded to the percent chance of sustaining a fall. For several cutoff values, the positive and negative predictive values were determined. The area under the curve values for the prediction rule was 0.89. Conclusion: In elderly people, the risk of sustaining a fall can be predicted, thereby allowing individualized decisions regarding the patient's management. Falls risk assessment score is a new self-reported tool that can be used in standard clinical practice by all health care professionals both in the outpatient and the acute hospital inpatient settings. Assessing for the falls risk would help to minimize the negative impact of falling on the patient's physical, psychological, and social functional abilities.

Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

“…We only assessed falls during six months; a longer follow-up would have increased the number of falls. The frequency of problems reported in the individual fall-risk questions was very low if compared to other studies on self-report fall-risk questionnaires [ 15 , 17 ]. This could be due to the good health state of our participants but it could also be due to how the questions were formulated (i.e., unclear wording or wording targets only serious problems).…”

The role of lower urinary tract symptoms in fall risk assessment tools in hospitals: a review

“…The literature search uncovered 23 fall risk scales. Of these, 11 were used for in-hospital patients or both in-hospital and institutionalized or community-dwelling older people [19][20][21][22][23][24][25][26][27][28][29] . The other 12 were intended for use in community-dwelling older people.…”

Towards Tailored Patient’s Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

“… Cardiovascular risk was assessed by SCORE [ 27 ]. Falls risk was assessed by falls risk assessment questionnaire (FRAS) [ 28 ]. …”