title: Self-report of missteps in older adults: a valid proxy of fall risk?
abstract: OBJECTIVE
  To evaluate the relationship between missteps and falls and to identify factors associated with missteps, potentially to generate a broader picture of fall risk.
  
  
  METHODS
  Prospective, observational cohort.
  
  
  METHODS
  General community.
  
  
  METHODS
  A sample of healthy, community-living older adults (N=266; age, 70-90y) who were cognitively intact and walked independently.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Baseline testing of gait, motor function, cognitive function, affect, and balance confidence was followed by a 12-month period in which subjects completed a daily log documenting the number of falls and missteps (defined as a trip, slip, or other loss of balance in which recovery occurred to prevent a fall).
  
  
  RESULTS
  Mean +/- SD participant age was 76.4+/-4.3 years. Of all the participants, 20.7% reported at least 1 misstep, and 25.6% of the participants reported at least 1 fall during the 12 months. Among subjects who had multiple falls, missteps were more common than falls by a ratio of 3:1 (P<.001). Subjects who reported multiple missteps were more likely to fall prospectively (relative risk=3.89). Missteps were associated with higher scores on the Geriatric Depression Scale (P=.009) and increased anxiety (P=.014), but were not associated with other known risk factors for falls, including gait and cognitive function.
  
  
  CONCLUSIONS
  The self-report of missteps may be a valuable tool in the research of falls and fall risk and may provide a way to identify patients at risk for falls before they fall.
authors.affiliation: Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Srygley
authors.forename: Talia
authors.initials: T
authors.lastname: Herman
authors.forename: Nir
authors.initials: N
authors.lastname: Giladi
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Hausdorff
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012494:Sampling Studies; D012647:Self-Assessment; D012680:Sensitivity and Specificity