Citation

Nandy S, Parsons S, Cryer C, Underwood MR, Rashbrook E, Carter YH, Eldridge S, Close J, Skelton DA, Taylor S, Feder G. J. Public Health (Oxford) 2004; 26(2): 138-143.

Affiliation

Department of General Practice and Primary Care, Queen Mary's School of Medicine and Dentistry, London.

Erratum On

J Public Health (Oxf) 2005;27(1):129-30.

Copyright

(Copyright © 2004, Oxford University Press)

DOI

10.1093/pubmed/fdh132

PMID

15284315

Abstract

BACKGROUND: There is no validated assessment of an older person's risk of falling that is easily applied in primary care. We aimed to develop a two-part tool for use in primary care or the community. Part 1 includes a rapid assessment of the individual's risk of falling for administration by clinical or non-clinical staff. Part 2 (for clinical staff) includes guidance on further assessment, referral and interventions. We assessed the predictive validity of part 1. METHODS: The tool was developed by an expert panel following the updating of an existing systematic review of community-based prospective studies identifying risk factors for falling and modified in accordance with the feedback from extensive piloting. We assessed predictive validity by a questionnaire survey sent at baseline and 6 months to a random sample of 1000 people aged over 65 in one Primary Care Group area. RESULTS: Five items were included in part 1: history of any fall in the previous year, four or more prescribed medications, diagnosis of stroke or Parkinson's disease, reported problems with balance, inability to rise from a chair without using arms. The presence of three or more risk factors had a positive predictive value for a fall in the next 6 months of 0.57 (95 per cent confidence interval 0.43-0.69). Less than three risk factors had a negative predictive value of 0.86 (0.82-0.89), and a specificity of 0.92 (0.88-0.94). CONCLUSION: The tool may be useful for identifying people who would benefit from further assessment of their risk of falling and appropriate intervention.

Language: en