title: Validating an evidence-based, self-rated fall risk questionnaire (FRQ) for older adults.
abstract: BACKGROUND
  Falls are a common, serious, and often unrecognized problem facing older adults. The objective of this study was to provide an initial clinical and statistical validation for a public health strategy of fall risk self-assessment by older adults using a Fall Risk Questionnaire (FRQ).
  
  
  METHODS
  Adults age 65+ (n=40) were recruited at a Los Angeles Veterans Affairs (VA) medical facility and at a local assisted living facility. Participants completed the FRQ self-assessment and results were compared to a "gold standard" of a clinical evaluation of risks using the American/British Geriatrics Society guidelines to assess independent predictors of falls: history of previous falls, fear of falling, gait/balance, muscle weakness, incontinence, sensation and proprioception, depression, vision, and medications. For the comparison, we used an iterative statistical approach, weighing items based on relative risk.
  
  
  RESULTS
  There was strong agreement between the FRQ and clinical evaluation (kappa=.875, p<.0001). Individual item kappa values ranged from .305-.832. After dropping one FRQ item (vision risk) because of inadequate agreement with the clinical evaluation (kappa=.139, p=.321), the final FRQ had good concurrent validity.
  
  
  CONCLUSIONS
  The FRQ goes beyond existing screening tools in that it is based on both evidence and clinical acceptability and has been initially validated with clinical examination data. A larger validation with longitudinal follow-up should determine the actual strength of the FRQ in predicting future falls.
authors.affiliation: Donald W. Reynolds Department of Geriatric Medicine University of Oklahoma College of Medicine, 921 NE 13th Street, VAMC (11 G), Oklahoma City, OK 73104, USA. Laurence-rubenstein@ouhsc.edu
authors.forename: Laurence Z
authors.initials: LZ
authors.lastname: Rubenstein
authors.forename: Rebecca
authors.initials: R
authors.lastname: Vivrette
authors.forename: Judith O
authors.initials: JO
authors.lastname: Harker
authors.forename: Judy A
authors.initials: JA
authors.lastname: Stevens
authors.forename: B Josea
authors.initials: BJ
authors.lastname: Kramer
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D040561:Assisted Living Facilities; D019317:Evidence-Based Medicine; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015141:Los Angeles; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014728:Veterans