title: Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people.
abstract: BACKGROUND
  Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people.
  
  
  METHODS
  The SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff.
  
  
  RESULTS
  All SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p < 0.01) for a single fall, 15.04 (p < 0.01) for recurrent falls, and 5.05 (p < 0.01) for fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status.
  
  
  CONCLUSIONS
  These results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.
authors.affiliation: Section for Health Promotion, Department of Health and Medical Care, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan. shimada@ncgg.go.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.forename: Megumi
authors.initials: M
authors.lastname: Suzukawa
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishizaki
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Hunkyung
authors.initials: H
authors.lastname: Kim
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires / Q000592:standards*