title: A simple clinical scale to stratify risk of recurrent falls in community-dwelling adults aged 65 years and older.
abstract: BACKGROUND
  Correct identification of people at risk for recurrent falls facilitates the establishment of preventive and rehabilitative strategies in older adults.
  
  
  OBJECTIVE
  The purposes of this study were: (1) to develop and validate a simple clinical scale to stratify risk for recurrent falls in community-dwelling elderly people based on easily obtained social and clinical items and (2) to evaluate the added value of 3 clinical balance tests in predicting this risk.
  
  
  METHODS
  This was a prospective measurement study.
  
  
  METHODS
  A population of 1,618 community-dwelling people over 65 years of age underwent a health checkup, including performance of 3 clinical balance tests: the One-Leg-Balance Test, the Timed "Up & Go" Test, and the Five-Times-Sit-to-Stand Test. Falls were recorded using a self-administered questionnaire that was completed a mean (SD) of 25+/-5 months after the visit. Participants were randomly divided into either group A (n=999), which was used to develop the scale, or group B (n=619), which was used to prospectively validate the scale.
  
  
  RESULTS
  Logistic regression analysis identified 4 variables that independently predicted recurrent falls in group A: history of falls, living alone, taking >or=4 medications per day, and female sex. Thereafter, 3 risk categories of recurrent falls (low, moderate, and high) were determined. Predicted probability of recurrent falls increased from 4.1% to 30.1% between the first and third categories. This scale subsequently was validated with great accuracy in group B. Only the Five-Times-Sit-to-Stand Test provided added value in the estimation of risk for recurrent falls, especially for the participants who were at moderate risk, in whom failure on the test (duration of >15 seconds) doubled the risk.
  
  
  CONCLUSIONS
  Falls were assessed only once, and length of follow-up was heterogeneous (18-36 months).
  
  
  CONCLUSIONS
  Clinicians could easily classify older patients in low-, moderate-, or high-risk groups of recurrent falls by using 4 easy-to-obtain items. The Five-Times-Sit-to-Stand Test provides added value to stratify risk for falls in people at moderate risk.
authors.affiliation: Department of Geriatrics, Centre d'Etudes et de Formation sur le Vieillissement, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.
authors.forename: Severine
authors.initials: S
authors.lastname: Buatois
authors.forename: Christine
authors.initials: C
authors.lastname: Perret-Guillaume
authors.forename: Rene
authors.initials: R
authors.lastname: Gueguen
authors.forename: Patrick
authors.initials: P
authors.lastname: Miget
authors.forename: Guy
authors.initials: G
authors.lastname: Vançon
authors.forename: Philippe
authors.initials: P
authors.lastname: Perrin
authors.forename: Athanase
authors.initials: A
authors.lastname: Benetos
mesh_terms: D000058:Accidental Falls; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D019338:Polypharmacy; D004856:Postural Balance; D011446:Prospective Studies; D012008:Recurrence; D012111:Residence Characteristics; D018570:Risk Assessment / Q000379:methods*; D012737:Sex Factors