title: Fall Risk Index predicts functional decline regardless of fall experiences among community-dwelling elderly.
abstract: OBJECTIVE
  The 21-item Fall Risk Index (FRI-21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI-21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community-dwelling elderly persons independent of fall risk.
  
  
  METHODS
  The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI-21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls.
  
  
  RESULTS
  A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05-1.20), FRI-21 ≥ 10 (OR 3.81, 95% CI 1.49-9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42-7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40-7.21) were significant independent risk factors for BADL decline within 1 year. FRI-21 ≥ 10 and intellectual activity dependence (≤ 3) remained significant predictors, even in selected non-fallers.
  
  
  CONCLUSIONS
  FRI-21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI-21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community-dwelling elderly persons.
authors.affiliation: Center for Southeast Asian Studies, Kyoto University Research Institute for Humanity and Nature, Kyoto, Japan. yasu325ap@gmail.com
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Ishimoto
authors.forename: Taizo
authors.initials: T
authors.lastname: Wada
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Eriko
authors.initials: E
authors.lastname: Fukutomi
authors.forename: Wenling
authors.initials: W
authors.lastname: Chen
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hirosaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakatsuka
authors.forename: Michiko
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Sakamoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ishine
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Okumiya
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Otsuka
authors.forename: Kozo
authors.initials: K
authors.lastname: Matsubayashi
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D007564:Japan; D008019:Life Style; D016015:Logistic Models; D008297:Male; D012372:ROC Curve; D012307:Risk Factors; D011795:Surveys and Questionnaires