Research Article

Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons: A Pilot Study

Table 1

Comparison of existing falls prediction tools for community-dwelling older adults.

Name of tool PublicationFall outcomeRisk factors used in the final modelFollow-up period (months)Area under the ROC-curve (if not stated otherwise)Number of participantsPerson with falls
(%)
Number of falls

AGS/BGS/AAOS algorithmAGS/BGS/AAOS [18]
Tested in [19]
Any fallSelf-reported and performance measures
How many falls have you had in the last year? Balance/gait impairment
12Likelihood ratio+ of 2.71, likelihood ratio− of 0.6111752 (44.4%)

Geriatric Postal Screening Survey (GPSS) Alessi et al., 2003 [20]Any fallSelf-reported
10 items: falls, balance problems, urinary incontinence, depression, memory loss, functional impairment, health perceptions (two questions), weight loss, polypharmacy, pain
12Sensitivity 0.94, specificity 0.51147

“Sturz-Risiko-check” (Falls-risk check) Anders et al., 2006 [17]Any FallSelf-reported
Questionnaires covering: vision problems, polymedication, depressive mood, stopped riding bicycle, neurological disease, balance disorder, weight loss, fear of falls, sit-to-stand, heart diseases, slower in activities of daily living, falls experience, injuries as consequences of falls
Cross-sectional study (test of reliability)117
Bongue et al., 2011 [21]Any fallSelf-reported and performance measure
Gender, living alone, psychoactive drug use, osteoarthritis, previous falls, change in the position of the arms during the one-leg balance
120.70 (0.67–0.73)1795563 (32%)
Buatois et al., 2010 [22]Self-reported and performance measure
History of falls, living alone, medications, female, five-times-sit-to-stand test
25619

FRAT-up Cattelani et al., 2015 [23]Any fallSelf-reported and performance measure
Age, cognition impairment, depression, comorbidity, dizziness and vertigo, fear of falling, female sex, gait problems, hearing impairment, history of falls, history of stroke, instrumental disability, living alone, number of medications, pain, Parkinson, physical activity limitation, physical disability, poor self-perceived health status, rheumatic disease, urinary incontinence, use of antiepileptics, use of antihypertensives, use of sedatives, vision impairment, walking aid use
36 0.64 (0.61–0.67)977215 (22%)
Covinsky et al., 2001 [24]Retrospective; fall or falls in the previous yearSelf-reported and performance measure
Abnormal mobility, balance difficulties or dizziness, fall in previous year
60 0.7195 (33%)197

EFST Cwikel et al., 1998 [25]Self-reported and performance measure
Near falls, fall in the past year, injurious fall in the past year, walking speed, examiner impression of gait

DFRA Demura et al., 2011 [26]Any fallSelf-reported and performance measure
50 items representing the five factors “symptoms of falling,” “physical function,” “disease and physical symptoms,” “environment,” and “behaviour and character”
Retrospective falls history85.4% correct classified 1122177 (16%)

FRAS El Miedany et al., 2011 [15]Any FallSelf-reported and performance measure
Age, history of any fall, history of more than 1 fall, slowing of walking speed/change in gait, loss of balance, weak hand grip, poor sight
Case-control 0.89 (0.86–0.92)985559 (57%)
Gadkaree et al., 2015 [27]Any fallAge, gender, race, self-reported balance problem, history of fall120.70 (0.67–0.78)2539
Hirase et al., 2014 [28]Self-reported
Have you fallen during the past year? Can you cross the street without resting (during a green traffic signal)? Can you continue to walk for an entire kilometer? Can you put on socks while standing on one leg? Can you wring out a wet towel? Have you admitted yourself to a hospital within the past year? Do you feel dizzy upon standing up? Have you ever had a stroke? Have you ever been diagnosed with diabetes? Do you take sleeping pills, antihypertensive drugs, or minor tranquillizers? Do you often wear sandals or slippers? Can you see the letters in a newspaper, or a person’s face, clearly? Can you hear a person’s voice during a conversation? Do you often stumble or slip in your own house? Do you have a fear of falling or do you hesitate to go out because you have a fear of falling?
(Bold = the seven questions used for the prospective study)
30.73 (0.62–0.83) for the seven bold factors; 0.82 (0.70–0.95) for all 15 factors29245 (15.6%)

Modified Johns Hopkins fall-risk assessment tool mJH-FRAT Hnizdo et al., 2013 [29]Any fallSelf-reported and performance measure
Age categories, fall history, elimination problems, high-risk medications, use of patient care equipment, limited mobility, altered cognition
During home health services (2 to 80 days) 0.66 (0.55–0.78)10733 (31%)

Physiological profile assessment Lord et al., 2003 [30]Self-reported and performance measure
Visual acuity-high contrast, yisual acuity-low contrast, edge contrast sensitivity, visual field dependence, proprioception, tactile sensitivity-ankle, vibration sense-knee, ankle dorsiflexion force, knee extension force, knee flexion force, reaction time-hand, reaction time-foot, sway on floor-eyes open, sway on floor-eyes closed, sway on foam rubber mat-eyes open, sway on foam rubber mat-eyes closed
Palumbo et al., 2015 [31]Self-reported and performance measure
Number of previous falls, number of drugs, self-perceived health status, previous falls (yes/no), drugs for dementia (yes/no), CESD depressed mood scale, if you are retired, do you have a veteran pension?, can you walk 300 meters twice without stopping?, gait speed, antihypertensive medication, do you have difficulty walking 400 meters on rough terrain?, antidepressants, walking posture: cautious attitude?, sibling with diabetes?, must you hold onto something (e.g., bannister) while climbing stairs?, quinolone antibacterials, antihypertensives
360.64 (0.61–0.67)9760.42 falls per person-year

LASA fall-risk profile Peeters et al., 2010 [32]At least 2 falls within 6 monthsSelf-reported and performance measure
How often did you fall during the past 12 months, including the last fall?, do you often have dizzy spells?, are you able to use your own method of transport or public transportation?, are you able to go up 15 steps without standing still?, are you able to cut your own toenails?, grip strength of right hand, grip strength of left hand, body weight, do you have a dog or a cat?, how concerned are you that you might fall when … (10 activities listed)?, do you sometimes drink alcohol?, what is the highest level of education that you completed with a certificate?
120.65 (0.58–0.72)40876 (recurrent fallers, 18.6%)
Pluijm et al., 2006 [33]Prospective, recurrent falling at 3-year follow-upSelf-reported and performance measure
≥2 falls in the previous year, dizziness, functional limitations, grip strength (men ≤ 56 kg, women ≤ 32 kg), body weight (women ≤ 62 kg; men ≤ 70 kg), fear of falling, dogs or cats in household, education ≥ 11 year, alcohol use (≥18 consumptions per week), alcohol use × education, ≥2 falls in the previous year × fear of falling
36 0.71 (0.67–0.74)121455.3%2570

Fall-risk assessment and screening tool FRAST Renfro and Fehrer, 2011 [14]Self-reported and performance measure
15 items: age, gender, fall history, daily physical activity level, number of prescription medicines, eye care, glasses or contacts, getting dizzy, use of assistive devices to walk, self-perceived risk behaviour, social activity, home-safety checklist, modified falls efficacy scale, mood scale, timed-up-and-go test.

FRQ Rubenstein et al., 2011 [13]Self-reported
I have fallen in the last 6 months. I am worried about falling. Sometimes, I feel unsteady when I am walking. I steady myself by holding onto furniture when walking at home. I use or have been advised to use a cane or walker to get around safely. I need to push with my hands to stand up from a chair. I have some trouble stepping up onto a curb. I often have to rush to the toilet. I have lost some feeling in my feet. I take medicine that sometimes makes me feel light-headed or more tired than usual. I take medicine to help me sleep or improve my mood. I often feel sad or depressed. Because I do not see well, I have difficulty avoiding hazards in my path, such as tree roots or electrical cords. (This last item was dropped due to low kappa with clinical evaluation.)

FROP-COM Russell et al., 2008 [34]13 risk factors covered with 26 questions.
Number of falls in the past 12 months, walking safely in the house, observation of balance, incontinence, number of medical conditions, vision deficit, assistance required to perform personal ADLs, number of fall-risk medications, assistance required to perform domestic ADLs, somatosensory deficit, cognitive status, level of physical activity, foot problems, number of medications, food intake, weight loss, nocturia, alcohol intake, inappropriate footwear, injury in past 12 months
120.68 (0.63–0.74)344164 (47.6%)

FROP-COM screen Russell et al., 2009 [35]Any fallSelf-reported and performance measure
Number of falls in the past 12 months, observation of balance, assistance required to perform domestic ADLs
120.73 (0.67–0.79)344164
Stalenhoef et al., 2002 [36]Prospective, recurrent falls (≥2 falls)Self-reported and performance measure
Women, age (≥80), ≥2 falls in previous year, depression, SCL90 ≥ 22; hand dynamometry (men ≤ 22 kg, women ≤ 12 kg), postural sway abnormal
36 0.79287

Thai-FRAT Jittima Thamarpirat et al., 2008 [37]Any fallSelf-reported and performance measure
Six factors: history of falls, impaired body balance, female, specific medication use, impaired visual acuity, Thai style house
24Positive Likelihood-Ratio: 2.34115

QuickScreen clinical fall-risk assessment Tiedemann et al., 2010 [38]Multiple fallsSelf-reported and performance measure
Falls in past year, total medications, psychoactive meds, visual acuity test (MAR), touch sensation test, alternate step test, sit-to-stand test, tandem stand test
120.72 (0.66–0.79)362179 (49%)
Tromp et al., 2001 [39]Any fallSelf-reported and performance measure
Previous falls, urinary incontinence, visual impairment, use of benzodiazepines
120.65128033%

Empty cells indicate that we did not found any corresponding information in the publications.