Maximum step length as a potential screening tool for falls in non-disabled older adults living in the community.
OBJECTIVE
Identification of the risk of falls in a cohort of interest is a prerequisite for a targeted fall prevention study. Motor tasks are widely used as baseline assessment in such studies, but there are only a few well-evaluated tests of motor performance to predict falls prospectively. This study was conducted to find out if the potential of the maximum step length (MSL) test can predict future falls in non-disabled older persons.


METHODS
A modified version of the MSL test was used for baseline assessment in 56 community-dwelling, non-disabled elderly persons (mean age 67.7 yrs, SD 6 yrs; 57% women). During a follow-up of 1 year, falls were recorded in a daily calendar.


RESULTS
During the follow-up, 30 persons (54%) fell, with no gender difference in reporting of falls between men and women. The adjusted mean valid step length and adjusted maximum valid step length were predictive of future falls with a sensitivity/specificity of 77%/62% and 70%/69%, respectively. Combining MSL test results with fall history increased sensitivity to 93% and 90%, respectively, but decreased specificity to 54% and 58%, respectively.


CONCLUSIONS
The MSL test is a feasible tool, with low requirements in space, predicting future falls in community-dwelling older persons. In combination with history of falls, the sensitivity of the test increased considerably.
Lindemann
Ulrich
U
Robert-Bosch-Hospital Stuttgart, Department of Clinical Gerontology, 70376 Stuttgart, Germany. ulrich.lindemann@rbk.de
Lundin-Olsson
Lillemor
L
Hauer
Klaus
K
Wengert
Mathias
M
Becker
Clemens
C
Pfeiffer
Klaus
K
D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D005260:Female; D005684:Gait; D015577:Geriatric Assessment / Q000379:methods*; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D004856:Postural Balance; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016138:Walking