Predicting the probability for falls in community-dwelling older adults.
OBJECTIVE
The objective of this retrospective case-control study was to develop a model for predicting the likelihood of falls among community-dwelling older adults.


METHODS
Forty-four community-dwelling adults (> or = 65 years of age) with and without a history of falls participated.


METHODS
Subjects completed a health status questionnaire and underwent a clinical evaluation of balance and mobility function. Variables that differed between fallers and nonfallers were identified, using t tests and cross tabulation with chi-square tests. A forward stepwise regression analysis was carried out to identify a combination of variables that effectively predicted fall status.


RESULTS
Five variables were found to be associated with fall history. These variables were analyzed using logistic regression. The final model combined the score on the Berg Balance Scale with a self-reported history of imbalance to predict fall risk. Sensitivity was 91%, and specificity was 82%.


CONCLUSIONS
A simple predictive model based on two risk factors can be used by physical therapists to quantify fall risk in community-dwelling older adults. Identification of patients with a high fall risk can lead to an appropriate referral into a fall prevention program. In addition, fall risk can be used to calculate change resulting from intervention.
Shumway-Cook
A
A
Department of Physical Therapy, Northwest Hospital, Seattle, WA 98133, USA. ashumway@nwhsea.org
Baldwin
M
M
Polissar
N L
NL
Gruber
W
W
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D004856:Postural Balance; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires