Skip to main content

Advertisement

SpringerLink
Log in

Association with and predictive capacity of self-perceived risk of falling in recurrent falls in older people: a prospective study

  • Short Communication
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Objective

Given the impact of recurrent falls in older people, risk evaluation for falling is an important part of geriatric assessment. Available clinical tools usually do not include patients’ self-perceived risk of falling. The objective of this study was to evaluate association with and predictive capacity of self-perceived risk of falling in recurrent falls.

Methods

Prospective cohort study. Patients attending a geriatric outpatients’ clinic were recruited (Pfeiffer score <5). A baseline assessment and follow-up over 14 months was scheduled for each patient. Self-perceived risk of falling was assessed through four questions. Association with falls was evaluated through relative risk, survival curves (Kaplan–Meier), and Cox regression (recurrent falls as outcome variables). Predictive capacity was evaluated through sensitivity, specificity, and predictive values.

Results

52 participants answered all 4 questions, and 15 participants (27.2 %) presented recurrent falls. Question 1 (Do you think you may fall in the next few months?) was associated with the occurrence of recurrent falls according to relative risk [3.88 (CI95 %:1.48–10.09)] and survival curves (log Rank, p 0.004). Such relationship is maintained over time. Cox-regression also showed significant difference in relation to the answer for question 1 and recurrent falls [hazard ratio 4.044 (CI: 1.410–11.597); p 0.009]. Sensitivity, specificity, positive and negative predictive values (question 1) were 53.3 % (CI95 %:28.1–78.6), 84.2 % (CI95 %:72.6–95.8), 57.1 % (CI95 %:31.2–83.1), and 82.1 % (CI95 %:70.0–94.1), respectively.

Conclusions

Patients’ self-perceived risk of falling is related to recurrent falls amongst people with a high risk of falling and this parameter might be useful in falling risk evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society (2011) Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 59(1):148–157

    Article  Google Scholar 

  2. National Collaborating Centre for Nursing and Supportive Care. Falls: the assessment and prevention of falls in older people. Clinical Guideline 21 (Internet). London: National Institute for Health and Clinical Excellence (NICE); 2004 Nov (cited 2011 Sept 30). Available from: http://www.nice.org.uk/CG021NICEguideline

  3. British Geriatrics Society (2001) Falls and postural Stability. Age Ageing 30(Suppl 4):1–48

    Article  Google Scholar 

  4. Rubenstein LZ (2006) Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 35(Suppl 2):ii37–ii41

    Article  PubMed  Google Scholar 

  5. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319(26):1701–1707

    Article  PubMed  CAS  Google Scholar 

  6. Ryynänen OP, Kivelä SL, Honkanen R et al (1991) Incidence of falling injuries leading to medical treatment in the elderly. Public Health 105(5):373–386

    Article  PubMed  Google Scholar 

  7. Nevitt MC, Cummings SR (1993) Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 41(11):1226–1234

    PubMed  CAS  Google Scholar 

  8. Schürch MA, Rizzoli R, Mermillod B et al (1996) A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 11(12):1935–1942

    Article  PubMed  Google Scholar 

  9. Gillespie WJ (2001) Extracts from « clinical evidence »: hip fracture. BMJ 322(7292):968–975

    Article  PubMed  CAS  Google Scholar 

  10. Nevitt MC, Cummings SR, Kidd S et al (1989) Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 261(18):2663–2668

    Article  PubMed  CAS  Google Scholar 

  11. Graafmans WC, Ooms ME, Hofstee HM et al (1996) Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 143(11):1129–1136

    Article  PubMed  CAS  Google Scholar 

  12. Fink HA, Wyman JF, Hanlon JT (2005) Falls. In: Tallis RC, Fillit HM (eds) Broclklehursts Geriatría (ed in spanish). Marban, Madrid, pp 1337–1346

    Google Scholar 

  13. Lord SR, Ward JA, Williams P et al (1994) Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 42(10):1110–1117

    PubMed  CAS  Google Scholar 

  14. Masud T, Morris RO (2001) Epidemiology of falls. Age Ageing 30(Suppl 4):3–7

    Article  PubMed  Google Scholar 

  15. Ganz DA, Higashi T, Rubenstein LZ (2005) Monitoring falls in cohort studies of community-dwelling older people: effect of the recall interval. J Am Geriatr Soc 53(12):2190–2194

    Article  PubMed  Google Scholar 

  16. Scheffer AC, Schuurmans MJ, van Dijk N et al (2008) Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 37(1):19–24

    Article  PubMed  Google Scholar 

  17. Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65

    PubMed  CAS  Google Scholar 

  18. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9(3):179–186

    Article  PubMed  CAS  Google Scholar 

  19. Tinetti ME, Richman D, Powell L (1990) Falls efficacy as a measure of fear of falling. J Gerontol 45(6):P239–P243

    Article  PubMed  CAS  Google Scholar 

  20. Tinetti ME (1986) Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 34(2):119–126

    PubMed  CAS  Google Scholar 

  21. International Classification of Diseases (ICD) (Internet). World Health Organization; cited 2011 Sep 30. Available from: http://www.who.int/classifications/icd/en/

  22. Herr KA, Mobily PR, Kohout FJ et al (1998) Evaluation of the Faces Pain Scale for use with the elderly. Clin J Pain 14(1):29–38

    Article  PubMed  CAS  Google Scholar 

  23. Pfeiffer E (1975) A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 23(10):433–441

    PubMed  CAS  Google Scholar 

  24. Leipzig RM, Cumming RG, Tinetti ME (1999) Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 47(1):30–39

    PubMed  CAS  Google Scholar 

  25. Leipzig RM, Cumming RG, Tinetti ME (1999) Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 47(1):40–50

    PubMed  CAS  Google Scholar 

  26. Rubenstein LZ, Josephson KR (2002) The epidemiology of falls and syncope. Clin Geriatr Med 18(2):141–158

    Article  PubMed  Google Scholar 

  27. Srikanth V, Beare R, Blizzard L et al (2009) Cerebral white matter lesions, gait, and the risk of incident falls: a prospective population-based study. Stroke 40(1):175–180

    Article  PubMed  Google Scholar 

  28. Snijder MB, van Schoor NM, Pluijm SMF et al (2006) Vitamin D status in relation to one-year risk of recurrent falling in older men and women. J Clin Endocrinol Metab 91(8):2980–2985

    Article  PubMed  CAS  Google Scholar 

  29. Coleman AL, Cummings SR, Yu F et al (2007) Binocular visual-field loss increases the risk of future falls in older white women. J Am Geriatr Soc 55(3):357–364

    Article  PubMed  Google Scholar 

  30. Perell KL, Nelson A, Goldman RL et al (2001) Fall risk assessment measures: an analytic review. J Gerontol A Biol Sci Med Sci 56(12):M761–M766

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We would like to thank Dr. Antonio Yuste Marco for the hard work done in research management and administration. We should like to thank Natalia Gonzalo and Esther Valldosera, for her invaluable work in data collection and quality control during field work.

Conflict of interest

All authors report no financial relationships with any organisations that might have an interest in the submitted work.

Author information

Authors and Affiliations

  1. Fundació Privada Sant Antoni Abat (Research Unit), Consorci Sanitari del Garraf (Department of Geriatrics), C/Sant Josep 21-23, 08800, Vilanova i la Geltrú, Barcelona, Spain

    César Gálvez-Barrón & Alejandro Rodríguez-Molinero

  2. Department of Geriatrics, Hospital Sant Antoni Abat - Consorci Sanitari del Garraf, C/Sant Josep 21-23, 08800, Vilanova i la Geltrú, Barcelona, Spain

    María Jesús Sanguino, Leire Narvaiza, Federico Cavestany, Isabel Collado, Oscar Macho & María Dolores Dapena

Authors
  1. César Gálvez-Barrón
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. María Jesús Sanguino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leire Narvaiza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Federico Cavestany
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Isabel Collado
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Oscar Macho
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. María Dolores Dapena
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alejandro Rodríguez-Molinero
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to César Gálvez-Barrón.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gálvez-Barrón, C., Sanguino, M.J., Narvaiza, L. et al. Association with and predictive capacity of self-perceived risk of falling in recurrent falls in older people: a prospective study. Aging Clin Exp Res 25, 591–596 (2013). https://doi.org/10.1007/s40520-013-0130-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-013-0130-x

Keywords

Search

Navigation