Measuring fall risk and predicting who will fall: Clinimetric properties of four fall risk assessment tools for residential aged care

Barker, Anna L., Nitz, Jennifer C., Choy, Nancy L. Low and Haines, Terry (2009) Measuring fall risk and predicting who will fall: Clinimetric properties of four fall risk assessment tools for residential aged care. Journals of Gerontology. Series A : Biological Sciences and Medical Sciences, 64A 8: 916-924. doi:10.1093/gerona/glp041


Author Barker, Anna L.
Nitz, Jennifer C.
Choy, Nancy L. Low
Haines, Terry
Title Measuring fall risk and predicting who will fall: Clinimetric properties of four fall risk assessment tools for residential aged care
Journal name Journals of Gerontology. Series A : Biological Sciences and Medical Sciences   Check publisher's open access policy
ISSN 1079-5006
1758-535X
Publication date 2009-08
Year available 2009
Sub-type Article (original research)
DOI 10.1093/gerona/glp041
Volume 64A
Issue 8
Start page 916
End page 924
Total pages 9
Place of publication Cary, NC, United States
Publisher Oxford University Press
Collection year 2010
Language eng
Formatted abstract
Background: The purpose of this prospective cohort study was to describe the clinimetric evaluation of four fall risk assessment tools (FRATs) recommended in best practice guidelines for use in residential aged care (RAC).

Methods: Eighty-seven residents, mean age 81.59 years (SD ±10.69), participated. The Falls Assessment Risk and Management Tool (FARAM), Peninsula Health Fall Risk Assessment Tool (PHFRAT), Queensland Fall Risk Assessment Tool (QFRAT), and Melbourne Fall Risk Assessment Tool (MFRAT) were completed at baseline, and 2 and 4 months, and falls occurring in the 6 months after the baseline assessment were recorded. Interrater agreement (kappa), predictive accuracy (survival analysis and Youden Index), and fit to the Rasch model were examined. Twelve-month fall history formed the predictive accuracy reference.

Results: Interrater risk classification agreement was high for the PHFRAT (к = .84) and FARAM (к = .81), and low for the QFRAT (к = .51) and MFRAT (к = .21). Survival analysis identified that 43%–66% of risk factors on each tool had no (p > .10) association with falls. No tool had higher predictive accuracy (Youden index) than the question, “has the resident fallen in past 12 months?” (p > .05). All tools did not exhibit fit to the Rasch model, invalidating summing of risk factor scores to provide an overall risk score.

Conclusion: The studied tools have poor clinimetric properties, casting doubt about their usefulness for identifying fall risk factors for those most at risk for falling and measuring fall risk in RAC.
Keyword Fall risk
Prognostic validity
Sensitivity
Specificity
Elderly persons
Nursing home
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes First published online: January 1, 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Thu, 03 Sep 2009, 07:47:17 EST by Mr Andrew Martlew on behalf of Physiotherapy