Predicting Which Older Adults Will or Will Not Fall Using the Fullerton Advanced Balance Scale

Abstract

Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the Fullerton Advanced Balance Scale. Objective The purpose of this study was to determine if the Fullerton Advanced Balance (FAB) scale can predict faller status in a group of independently functioning older adults. Design 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. For the purpose of this study, a faller was classified as an older adult with a history of 2 or more falls in the previous 12 months. Setting Multipurpose senior centers in an urban community. Participants A sample of independently functioning older adults (N=192; mean age ± SD, 77±6.5y). Interventions Not applicable. Main Outcome Measures FAB scale, a retrospective history of falls. Results Binary logistic regression analysis indicated that the total FAB scale score could be used to predict faller status (as determined by a retrospective self-reported fall history). In the present sample, the probability of falling increased by 8% with each 1-point decrease in total FAB scale score. Receiver operating characteristic analysis determined that a cut-off score of 25 out of 40 on the FAB scale produced the highest sensitivity (74.6%) and specificity (52.6%) in predicting faller status. Five individual test items on the FAB scale were particularly predictive of faller status and could be combined to form a short version of the scale that may be even more predictive of faller status and require less time to administer. Conclusions The FAB scale is a predictive measure of faller status when used with independently functioning older adults. A practitioner can be confident in more than 7 out of 10 cases that an older adult who scores 25 or lower on the FAB scale is at high risk for falls and in need of immediate intervention.