Citation

Rubenstein LZ, Vivrette R, Harker JO, Stevens JA, Kramer BJ. J. Saf. Res. 2011; 42(6): 493-499.

Affiliation

Donald W. Reynolds Department of Geriatric Medicine University of Oklahoma College of Medicine, 921 NE 13th Street, VAMC (11 G), Oklahoma City, OK 73104, USA; Geriatric Research, Education & Clinical Center (GRECC), Greater Los Angeles VA Medical Center (11E), 16111 Plummer Street; Sepulveda, CA 91343, USA; UCLA School of Medicine and GRECC, Greater Los Angeles VA Medical Center, 16111 Plummer Street (11E); Sepulveda, CA 91343, USA.

Copyright

(Copyright © 2011, U.S. National Safety Council, Publisher Elsevier Publishing)

DOI

10.1016/j.jsr.2011.08.006

PMID

22152267

Abstract

BACKGROUND: Falls are a common, serious, and often unrecognized problem facing older adults. The objective of this study was to provide an initial clinical and statistical validation for a public health strategy of fall risk self-assessment by older adults using a Fall Risk Questionnaire (FRQ). METHODS: Adults age 65+ (n=40) were recruited at a Los Angeles Veterans Affairs (VA) medical facility and at a local assisted living facility. Participants completed the FRQ self-assessment and results were compared to a "gold standard" of a clinical evaluation of risks using the American/British Geriatrics Society guidelines to assess independent predictors of falls: history of previous falls, fear of falling, gait/balance, muscle weakness, incontinence, sensation and proprioception, depression, vision, and medications. For the comparison, we used an iterative statistical approach, weighing items based on relative risk. RESULTS: There was strong agreement between the FRQ and clinical evaluation (kappa=.875, p<.0001). Individual item kappa values ranged from .305-.832. After dropping one FRQ item (vision risk) because of inadequate agreement with the clinical evaluation (kappa=.139, p=.321), the final FRQ had good concurrent validity. CONCLUSIONS: The FRQ goes beyond existing screening tools in that it is based on both evidence and clinical acceptability and has been initially validated with clinical examination data. A larger validation with longitudinal follow-up should determine the actual strength of the FRQ in predicting future falls.

Language: en