Retrospective evaluation of the world falls guidelines-algorithm in older adults.

Background The World Falls Guidelines (WFG) propose an algorithm that classifies patients as low-, intermediate-, and high-risk. We evaluated different operationalizations of the WFG algorithm and compared its predictive performance to other screening tools for falls, namely: the American Geriatrics...

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Publicado en:Age & Ageing Vol. 53; no. 10; pp. 1 - 9
Autores principales: van de Loo, Bob, Heymans, Martijn W, Medlock, Stephanie, Abu-Hanna, Ameen, van der Velde, Nathalie, Schoor, Natasja M van
Formato: Artículo
Publicado: Oxford University Press / USA 2024
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Retrospective evaluation of the world falls guidelines-algorithm in older adults.
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          van de Loo, Bob
          Heymans, Martijn W
          Medlock, Stephanie
          Abu-Hanna, Ameen
          van der Velde, Nathalie
          Schoor, Natasja M van
        affil:
          Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science , De Boelelaan 1117, Amsterdam, Netherlands
          Amsterdam UMC location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine , Meibergdreef 9, Amsterdam, Netherlands
          Amsterdam Public Health research institute, Aging and Later Life , Meibergdreef 9, Amsterdam, The Netherlands
          Amsterdam UMC location University of Amsterdam , Department of Medical Informatics, Meibergdreef 9, Amsterdam, Netherlands
      su:
        Netherlands
        Retrospective studies
        Old age
        Medical protocols
        Risk assessment
        Frail elderly
        Descriptive statistics
        Geriatric assessment
        Comparative studies
        Accidental falls
        Algorithms
        Sensitivity & specificity (Statistics)
      sug:
        subj:
          Retrospective studies
          Old age
          Netherlands
          Medical protocols
          Risk assessment
          Frail elderly
          Descriptive statistics
          Geriatric assessment
          Comparative studies
          Accidental falls
          Algorithms
          Sensitivity & specificity (Statistics)
      keyword:
        adult
        aging
        calendars
        falls
        follow-up
        frailty
        geriatrics
        guidelines
        older adult
        older people
        prediction
        proxy
        screening
        stratification
        trees (plant)
        adult
        aging
        calendars
        falls
        follow-up
        frailty
        geriatrics
        guidelines
        older adult
        older people
        prediction
        proxy
        screening
        stratification
        trees (plant)
      ab: Background The World Falls Guidelines (WFG) propose an algorithm that classifies patients as low-, intermediate-, and high-risk. We evaluated different operationalizations of the WFG algorithm and compared its predictive performance to other screening tools for falls, namely: the American Geriatrics Society and British Geriatrics Society (AGS/BGS) algorithm, the 3KQ on their own and fall history on its own. Methods We included data from 1509 adults aged ≥65 years from the population-based Longitudinal Aging Study Amsterdam. The outcome was ≥1 fall during 1-year follow-up, which was ascertained using fall calendars. The screening tools' items were retrospectively operationalized using baseline measures, using proxies where necessary. Results Sensitivity ranged between 30.9–48.0% and specificity ranged between 77.0–88.2%. Operationalizing the algorithm with the 3KQ instead of fall history yielded a higher sensitivity but lower specificity, whereas operationalization with the Clinical Frailty Scale (CFS) classification tree instead of Fried's frailty criteria did not affect predictive performance. Compared to the WFG algorithm, the AGS/BGS algorithm and fall history on its own yielded similar predictive performance, whereas the 3KQ on their own yielded a higher sensitivity but lower specificity. Conclusion The WFG algorithm can identify patients at risk of a fall, especially when the 3KQ are included in its operationalization. The CFS and Fried's frailty criteria may be used interchangeably in the algorithm's operationalization. The algorithm performed similarly compared to other screening tools, except for the 3KQ on their own, which have higher sensitivity but lower specificity and lack clinical recommendations per risk category.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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