title: Functional performance as a predictor of injurious falls in older adults.
abstract: OBJECTIVE
  To determine whether a performance battery and its components aid in predicting injurious falls.
  
  
  METHODS
  Longitudinal analysis; prospective cohort study.
  
  
  METHODS
  Clinical site.
  
  
  METHODS
  Boston-area community-dwelling adults (N = 755; mean age ± SD 78.1 ± 5.4, 64.1% female, 77.6% white).
  
  
  METHODS
  Baseline functional performance was determined according to the Short Physical Performance Battery (SPPB), measuring balance, gait speed, and five repeated chair stands. Fall history (past year) and efficacy in performing 10 daily activities without falling were assessed. Falls were assessed using a daily calendar over 4 years. Injurious falls were defined as resulting in fractures, sprains, dislocations, pulled or torn muscles, ligaments, or tendons or seeking medical attention.
  
  
  RESULTS
  Poorest chair stand performance (≥16.7 seconds) was associated with greater hazard of injurious falls than in all other chair stand performance groups (hazard ratio (HR) = 1.96, 95% confidence interval (CI) = 1.18-3.26 for ≥ 16.7 vs. 13.7-16.6 seconds; HR = 1.65, 95% CI = 1.07-2.55 for ≥ 16.7 vs. 11.2-13.6 seconds, HR = 1.60, 95% CI = 1.03-2.48 for ≥ 16.7 vs. <11.2 seconds). SPPB did not predict injurious falls. Fall history predicted injurious falls (HR = 1.82, 95% CI = 1.39-2.39); falls efficacy did not. Fall history and a slow chair stand (<16.7 seconds) had a 2-year cumulative incidence rate of an injurious fall of 46% (95% CI = 0.34-0.58), nearly the combined rate of a positive fall history (0.29, 95% CI = 0.25-0.34) and a slow chair stand alone (0.21, 95% CI = 0.13-0.30).
  
  
  CONCLUSIONS
  An easily administered chair stand test may be sufficient for evaluating performance as part of a risk stratification strategy for injurious falls.
authors: Spaulding Rehabilitation Hospital, Boston, Massachusetts; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, Massachusetts; Health and Disability Research Institute, School of Health, Boston University, Boston, Massachusetts.
authors: Rachel E
authors: RE
authors: Ward
authors: Suzanne G
authors: SG
authors: Leveille
authors: Marla K
authors: MK
authors: Beauchamp
authors: Thomas
authors: T
authors: Travison
authors: Neil
authors: N
authors: Alexander
authors: Alan M
authors: AM
authors: Jette
authors: Jonathan F
authors: JF
authors: Bean
mesh_terms: D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology*; D018570:Risk Assessment; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: aged; falls; injury; risk assessment