Abstract
BackgroundObjective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people.MethodsThe SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff.ResultsAll SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p < 0.01) for a single fall, 15.04 (p < 0.01) for recurrent falls, and 5.05 (p < 0.01) for fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status.ConclusionThese results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.
Highlights
Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests
Of the participants with fractures, 74 (39.4%) had a femoral fracture, 68 (36.2%) participants had a fracture of the skull, trunk, pelvic, or lower leg, and 46 (24.5%) experienced a fracture of the arm
In conclusion, this study developed the subjective risk rating of specific tasks (SRRST) as a subjective assessment for identifying risk of falls in the frail elderly people
Summary
Objective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. Numerous studies have identified factors that predict an increased risk of falls, and many validated assessment tools have been developed to determine fall risks for elderly people [2,3]. Our previous studies have identified the best mobility tests [6] and a physical performance test [7] for predicting falls in the elderly. Some subjective assessments by care staff have been developed for identifying fall risks in frail elderly adults [11,12,13]. Staff members possess knowledge of their residents’ potential fall risk over a
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