An Examination of the Predictive Properties of the Fullerton Advanced Balance (FAB) Scale.

Abstract

Through early detection of balance and mobility limitations, preventative strategies can be implemented to reduce the risk factors that predispose older adults to falls and fall-related injuries. The development of performance-based tests that are sensitive to subtle changes in balance abilities and also capable of identifying older adults at different levels of fall risk are particularly important. PURPOSE: The purpose of this study was to determine if the Fullerton Advanced Balance (FAB) scale can predict faller status in a sample of 200 independently functioning older adults (60–93 years). METHODS: A cross-sectional design was used to establish the sensitivity and specificity of the FAB scale to predict faller status (based on a retrospective self-reported fall history). Independently-residing older adults attended a community fall risk screening event and were assessed using multiple measures of balance and gait. To be eligible for inclusion in the study, participants had to be: (a) 65 years or older, (b) independently residing in the community, (c) of normal cognition, (d) able to ambulate independently for a distance of 200 feet, and (e) not diagnosed with a progressive neurological condition or severe musculoskeletal condition. The session was approximately 90 minutes in duration. RESULTS: Binary logistic regression analysis indicated that the total FAB scale score can be used to predict faller status. In the present sample, the likelihood of falling increased by 10% with each one point decrease in total FAB scale score. Receiver Operating Curve (ROC) analysis determined that a cut-off score of 26/40 on the FAB scale produced the highest sensitivity (80.3%) and specificity (47.5%) in predicting faller status. CONCLUSION: The FAB scale demonstrates strong predictive validity with respect to faller status and can be used to identify independently functioning older adults at high risk for falls who should be referred to a fall risk reduction program.