Predicting risk of the fall among aged adult residents of a nursing home

Farshad Sharifi, Hossein Fakhrzadeh, Alireza Memari, Baharak Najafi, Neda Nazari, Mahtab Alizadeh Khoee, Seyed Masoud Arzaghi, Fariborz Bakhtiari, Siamak Ghasemi, Seyedeh Nahaleh Salavatian, Neda Mehrdad, Reza Fadaayevatan, Vida Alizad, Ian Philp
Archives of Gerontology and Geriatrics 2015, 61 (2): 124-30

BACKGROUND: Fall is one of the most important outcomes of geriatric medicine. The European Assessment System (EASY) Care Standard provides a tool for assessing the risk of the falls. We aimed to evaluate the validity of the Easy-Care risk of the falls (ECRF) sub-score among the residents of a large nursing home.

METHOD: A longitudinal study was conducted within a maximum of 34 months following up for falling in Kahrizak Charity Foundation. At the baseline the demographic, mental status and the depression data of 194 subjects aged ≥60 was collected. The Easy-Care standard tools and Performance-Oriented Mobility Assessment (POMA) were also used for data collecting. The time, location, and cause of the falls were recorded immediately after each fall incident. The Correlation between POMA and ECRF scores and the factor analysis of ECRF were considered as the concurrent and construct validity respectively. The Factor affecting the fall occurrence was assessed using the Cox-regression model.

RESULT: The mean age of the participants was 76.02 (SD 8.82). Fifty two individuals (27.3%) fell at least once during the mean 756 (SD 187)-day follow up. The Spearman correlation coefficient between ECRF and POMA scores was -0.458 (P<0.01). Three components were detected in the factor analysis of the ECRF. In the univariate Cox-regression model, the hazard ratio was 1.04 (CI: 1.00-1.07) for each score increase of the ECRF. For the six-month follow-up, at the ECRF cut-off point two of eight, the sensitivity and specificity were calculated as 85.7% and 64.5% respectively.

CONCLUSION: It seems that the ECRF is a valid tool for predicting the next 6 months' fall incidents in older adults.

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