History of falls and fear of falling are predictive of future falls: Outcome of a fall rate model applied to the Swiss CHEF Trial cohort

Frontiers in Aging

Aging

Philippe Zysset¹  Christina Wapp¹  Anne-Gabrielle Mittaz Hager²  Roger Hilfiker² 

[1] ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland;HES-SO Valais-Wallis, School of Health Sciences of Physiotherapy, Leukerbad, Switzerland;

关键词: older adults;    falls;    prediction;    risk factors;    count regression;   

DOI  :  10.3389/fragi.2022.1056779

 received in 2022-09-29, accepted in 2022-11-11,  发布年份 2022

来源: Frontiers

【 摘 要 】

Background: A third of adults aged 65 years and older fall every year, and falls are a common cause of unintentional injuries. Accurate identification of people at risk of falling is an important step in the implementation of preventive strategies.Objective: Our aim was to investigate the association of fall risk factors with number of reported falls in terms of incidence rate ratios and to develop a fall rate prediction model.Methods: In the randomized controlled trial Swiss CHEF, multiple fall risk variables were assessed in community-dwelling older adults at baseline examination, including age, sex, body mass index, fear of falling, number of falls during the prior 12 months, scores on several physical performance tests, comorbidities, and quality of life. Over the following 6 months, interventions were administered in the form of three home-based exercise programs. Participants were subsequently followed up for another 6 months. Falls were reported prospectively using monthly calendars. Incidence rate ratios were derived via negative binomial regression models. Variable selection for the prediction model was conducted using backward elimination and the least absolute shrinkage and selection operator method; the model with the smallest prediction error was then identified.Results: Associations with the number of reported falls were found for number of prior falls, fear of falling, balance and gait deficits, and quality of life. The final model was derived via backward elimination, and the predictors included were prior number of falls and a measure of fear of falling.Outcome: Number of prior falls and fear of falling can be used as predictors in a personalized fall rate estimate for community-dwelling older adults. Recurrent fallers having experienced four or more falls are especially at risk of falling again.

【 授权许可】

Unknown   
Copyright © 2022 Wapp, Mittaz Hager, Hilfiker and Zysset.