Preliminary evaluation of a self-guided fall risk assessment tool for older adults

Abstract Background Falls are common undesirable events for older adults in institutions. Even though the patient’s fall risk may be scored on admission, the medication-induced fall risk may be ignored. This study developed a preliminary categorization of fall-risk-increasing drugs (FRIDs) to be added as a risk factor to the existing fall risk assessment tool routinely used in geriatric care units. Methods Medication use data of older adults who had experienced at least one fall during a hospital ward or a nursing home stay within a 2-year study period were retrospectively collected from patient records. Medicines used were classified into three risk categories (high, moderate and none) according to the fall risk information in statutory summaries of product characteristics (SmPCs). The fall risk categorization incorporated the relative frequency of such adverse drug effects (ADEs) in SmPCs that were known to be connected to fall risk (sedation, orthostatic hypotension, syncope, dizziness, drowsiness, changes in blood pressure or impaired balance). Also, distribution of fall risk scores assessed on admission without considering medications was counted. Results The fall-experienced patients (n = 188, 128 from the hospital and 60 from nursing home records) used altogether 1748 medicaments, including 216 different active substances. Of the active substances, 102 (47%) were categorized as high risk (category A) for increasing fall risk. Fall-experienced patients (n = 188) received a mean of 3.8 category A medicines (n = 710), 53% (n = 375) of which affected the nervous and 40% (n = 281) the cardiovascular system. Without considering medication-related fall risk, 53% (n = 100) of the patients were scored having a high fall risk (3 or 4 risk scores). Conclusion It was possible to develop a preliminary categorization of FRIDs basing on their adverse drug effect profile in SmPCs and frequency of use in older patients who had experienced at least one documented fall in a geriatric care unit. Even though more than half of the fall-experienced study participants had high fall risk scores on admission, their fall risk might have been underestimated as use of high fall risk medicines was common, even concomitant use. Further studies are needed to develop the FRID categorization and assess its impact on fall risk.

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Cross-cultural adaptation and validation of the Spanish version of the Johns Hopkins Fall Risk Assessment Tool

Disability and Rehabilitation ◽

10.1080/09638288.2020.1800836 ◽

2020 ◽

pp. 1-8

Author(s):

Francisco José Ariza-Zafra ◽

Rita P. Romero-Galisteo ◽

María Ruiz-Muñoz ◽

Antonio I. Cuesta-Vargas ◽

Manuel González-Sánchez

Keyword(s):

Risk Assessment ◽

Cultural Adaptation ◽

Fall Risk ◽

Assessment Tool ◽

Cross Cultural ◽

Spanish Version ◽

Risk Assessment Tool ◽

Fall Risk Assessment ◽

Cross Cultural Adaptation

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Comparison of Fall Risk Assessment Tools for Older Indonesian Adults in the Elderly Home and the Community

The Indonesian Journal of Occupational Safety and Health ◽

10.20473/ijosh.v8i3.2019.241-249 ◽

2019 ◽

Vol 8 (3) ◽

pp. 241

Author(s):

Indri Hapsari Susilowati ◽

Susiana Nugraha ◽

Sabarinah Sabarinah ◽

Bonardo Prayogo Hasiholan ◽

Supa Pengpid ◽

...

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Fall Risk ◽

Assessment Tool ◽

The Elderly ◽

Risk Assessment Tool ◽

Fall Risk Assessment ◽

Elderly Home ◽

Balance Confidence ◽

Confidence Scale

Introduction: One of the causes of disability among elderly is falling. The ability to predict the risk of falls among this group is important so that the appropriate treatment can be provided to reduce the risk. The objective of this study was to compare the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) Initiative from the Centers for Disease Control and Prevention (CDC) and The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) from the Johns Hopkins University. Methods: This study used the STEADI tool, JHFRAT, Activities-Specific Balance Confidence Scale (ABC), and The Geriatric Depression Scale (GDS). The study areas were in community and elderly home in both public and private sectors and the samples were 427 after cleaning. Results: The results for the STEADI and JHFRAT tools were similar where the respondents at highest risk of falling among women (STEADI: 49%; JHFRAT: 3.4%), in Bandung area (63.5%; 5.4%), in private homes (63.3%; 4.4%), non-schools (54.6%; 6.2%), aged 80 or older (64.8%; 6.7%) and not working (48.9%;3.3%). The regression analysis indicated that there was a significant relationship between the risk factors for falls in the elderly determined by the JHFRAT and STEADI tools: namely, region, type of home, age, disease history, total GDS and ABC averages. Conclusion: Despite the similarity in the risk factors obtained through these assessments, there was a significant difference between the results for the STEADI tool and the JHFRAT. The test strength was 43%. However, STEADI is more sensitive to detect fall risk smong elderly than JHFRATKeywords: Activities-Specific Balance Confidence scale, elderly, fall risk,The Johns Hopkins Fall Risk Assessment Tool, the Stopping Elderly Accidents, Deaths, & Injuries

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