The optimal sequence and selection of screening test items to predict fall risk in older disabled women: the Women's Health and Aging Study.

Background: Falls are a major cause of disability, dependence, and death in older people. Brief screening algorithms may be helpful in identifying risk and leading to more detailed assessment. Our aim was to determine the most effective sequence of falls screening test items from a wide selection of...

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Publicado en:Journals of Gerontology Series A: Biological Sciences & Medical Sciences Vol. 63; no. 10; pp. 1082 - 1089
Autores principales: Lamb SE, McCabe C, Becker C, Fried LP, Guralnik JM, Lamb, Sarah E, McCabe, Chris, Becker, Clemens, Fried, Linda P, Guralnik, Jack M
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Oct2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2008
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      pub: Oxford University Press / USA
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        atl: The optimal sequence and selection of screening test items to predict fall risk in older disabled women: the Women's Health and Aging Study.
      aug:
        au:
          Lamb SE
          McCabe C
          Becker C
          Fried LP
          Guralnik JM
          Lamb, Sarah E
          McCabe, Chris
          Becker, Clemens
          Fried, Linda P
          Guralnik, Jack M
        affil: Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
      sug:
        subj:
          Accidental Falls Risk Factors
          Aged
          Aged, 80 and Over
          Balance, Postural Evaluation
          Body Mass Index
          Clinical Assessment Tools
          Data Analysis Software
          Data Analysis, Statistical
          Depression Epidemiology
          Female
          Gait Analysis
          Geriatric Depression Scale
          Geriatric Functional Assessment
          Odds Ratio
          Polypharmacy
          Prospective Studies
          Psychological Tests
          Self Report
          Sensitivity and Specificity
          Human
          Aged: 65+ years
          Aged, 80 & over
          Female
      ab: Background: Falls are a major cause of disability, dependence, and death in older people. Brief screening algorithms may be helpful in identifying risk and leading to more detailed assessment. Our aim was to determine the most effective sequence of falls screening test items from a wide selection of recommended items including self-report and performance tests, and to compare performance with other published guidelines.Methods: Data were from a prospective, age-stratified, cohort study. Participants were 1002 community-dwelling women aged 65 years old or older, experiencing at least some mild disability. Assessments of fall risk factors were conducted in participants' homes. Fall outcomes were collected at 6 monthly intervals. Algorithms were built for prediction of any fall over a 12-month period using tree classification with cross-set validation.Results: Algorithms using performance tests provided the best prediction of fall events, and achieved moderate to strong performance when compared to commonly accepted benchmarks. The items selected by the best performing algorithm were the number of falls in the last year and, in selected subpopulations, frequency of difficulty balancing while walking, a 4 m walking speed test, body mass index, and a test of knee extensor strength. The algorithm performed better than that from the American Geriatric Society/British Geriatric Society/American Academy of Orthopaedic Surgeons and other guidance, although these findings should be treated with caution.Conclusions: Suggestions are made on the type, number, and sequence of tests that could be used to maximize estimation of the probability of falling in older disabled women.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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