How predictive is a home-safety checklist of indoor fall risk for the elderly living in the community?

Abstract

Development and evaluation of a homesafety checklist of indoor fall risk for the elderly living in the community. Methods: A checklist of indoor fall risk was developed in a Delphi procedure as part of a baseline assessment of fall risk. Based on the number of falls in the previous year, the 1238 responders to a postal questionnaire on occurrence, risk factors, and consequences of falls in community-living elderly of 70 years or over were divided into three groups: non fallers, one-time fallers and recurrent fallers (22 falls). Out of each group, 130 subjects were randomly selected and stratified on age and gender (n=392), 311 of whom (79%) were available for participation in a prospective study: a baseline assessment including home-safety assessment of indoor fall risk, and a subsequent 36-week follow-up procedure with telephone calls every six weeks. Outcome variables were indoor falls and the number of subjects with indoor falls during follow-up. Prevalences of potential risk factors were determined. In addition, associations between potential risk factors for indoor falls and indoor falls during follow-up were calculated by bivariate analysis. Results: Follow-up was completed by 293 subjects and data from 287 subjects were available for analysis. During follow-up, 198 falls were reported by 96 participants (32%). Two persons had a hip fracture (1%) and four had other fractures (2%). A total of 135 indoor falls were reported by 63 (21%) and 63 outdoor falls by 45 persons (15%). Potential risk factors for indoor falls belong equally to structural (immobile) Paul Stalenhoef, general practitioner. Jos Diederiks, medical sociologist. AndrC Knottnerus, professor of general practice. Harry Crebolder, professor of general practice.

Lack of Effectiveness of a Multidisciplinary Fall‐Prevention Program in Elderly People at Risk: A Randomized, Controlled Trial

“…21,22 Environmental hazards were identified and registered using a home-safety checklist. 23 In addition, the Falls Handicap Inventory (FHI) 24 was used to assess handicaps associated with repeated falls. The participants received recommendations with regard to behavioral change, functional needs, and safety within the home environment.…”

Fall-risk screening test

“…Selection of communitydwelling elderly with a high risk of falling is difficult. Several studies on the prediction of falls and recurrent falls in elderly people have been published [13,19], al-though mostly without evidence of feasibility. The aim of the present study, using data from a large prospective cohort of elderly, including similar numbers of men and women, is to develop a fall-risk screening test for community-dwelling older adults.…”

A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review

“…Only two authors reported sensitivity and specificity of checklists items [ 62 , 103 ]. Thirty studies reported inter-rater reliability [ 8 , 14 , 15 , 19 , 23 , 51 , 54 , 57 – 59 , 72 , 77 , 80 , 81 , 84 , 85 , 98 , 103 , 106 , 110 – 112 , 115 , 120 – 123 , 133 , 135 , 152 ]; fewer reported test-retest reliability [ 36 , 81 , 98 , 122 ] or internal consistency [ 53 , 81 , 86 , 97 ]. The inter-rater reliability of checklists, when used by professional and lay older adult pairs, was reported in four studies; three showed that professionals identified more hazards than lay older adults [ 23 , 111 , 133 ] and one showed that lay older adults reported more of some hazards, while professionals reported more of other hazards [ 110 ].…”

“…From these documents, 42 unique checklists were identified and included in the second stage of this review [ 8 , 15 – 17 , 20 – 23 , 34 , 44 , 49 , 51 , 53 , 58 , 66 , 69 , 72 , 79 , 82 , 86 , 87 , 98 , 102 , 108 , 110 – 112 , 115 , 121 , 124 , 126 , 132 , 135 , 137 , 139 , 140 , 144 , 148 – 152 ].…”