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A multifactorial approach for understanding fall risk in older people

Kim Delbaere UGent, Jacqueline CT Close, Jörg Heim, Perminder S Sachdev, Henry Brodaty, Melissa J Slavin, Nicole A Kochan and Stephen R Lord (2010) JOURNAL OF THE AMERICAN GERIATRICS SOCIETY. 58(9). p.1679-1685
abstract
OBJECTIVE: To identify the interrelationships and discriminatory value of a broad range of objectively measured explanatory risk factors for falls. DESIGN: Prospective cohort study with 12-month follow-up period. SETTING: Community sample. PARTICIPANTS: Five hundred community-dwelling people aged 70 to 90. MEASUREMENTS: All participants underwent assessments on medical, disability, physical, cognitive, and psychological measures. Fallers were defined as people who had at least one injurious fall or at least two noninjurious falls during a 12-month follow-up period. RESULTS: Univariate regression analyses identified the following fall risk factors: disability, poor performance on physical tests, depressive symptoms, poor executive function, concern about falling, and previous falls. Classification and regression tree analysis revealed that balance-related impairments were critical predictors of falls. In those with good balance, disability and exercise levels influenced future fall risk-people in the lowest and the highest exercise tertiles were at greater risk. In those with impaired balance, different risk factors predicted greater fall risk-poor executive function, poor dynamic balance, and low exercise levels. Absolute risks for falls ranged from 11% in those with no risk factors to 54% in the highest-risk group. CONCLUSIONS: A classification and regression tree approach highlighted interrelationships and discriminatory value of important explanatory fall risk factors. The information may prove useful in clinical settings to assist in tailoring interventions to maximize the potential benefit of falls prevention strategies.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
WOMEN, VALIDATION, AGE, PREVENTION, ADULTS, CLASSIFICATION TREE, RANDOMIZED CONTROLLED-TRIAL, decision tree, Trails B, depression, activities of daily life, aged, accidental falls, DEPRESSION, HEALTH, EXERCISE
journal title
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
J. Am. Geriatr. Soc.
volume
58
issue
9
pages
1679 - 1685
Web of Science type
Article
Web of Science id
000281549000008
JCR category
GERONTOLOGY
JCR impact factor
3.913 (2010)
JCR rank
2/28 (2010)
JCR quartile
1 (2010)
ISSN
0002-8614
DOI
10.1111/j.1532-5415.2010.03017.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have retained and own the full copyright for this publication
id
953730
handle
http://hdl.handle.net/1854/LU-953730
date created
2010-05-27 06:06:26
date last changed
2015-06-17 11:25:53
@article{953730,
  abstract     = {OBJECTIVE: To identify the interrelationships and discriminatory value of a broad range of objectively measured explanatory risk factors for falls.
DESIGN: Prospective cohort study with 12-month follow-up period.
SETTING: Community sample.
PARTICIPANTS: Five hundred community-dwelling people aged 70 to 90.
MEASUREMENTS: All participants underwent assessments on medical, disability, physical, cognitive, and psychological measures. Fallers were defined as people who had at least one injurious fall or at least two noninjurious falls during a 12-month follow-up period.
RESULTS: Univariate regression analyses identified the following fall risk factors: disability, poor performance on physical tests, depressive symptoms, poor executive function, concern about falling, and previous falls. Classification and regression tree analysis revealed that balance-related impairments were critical predictors of falls. In those with good balance, disability and exercise levels influenced future fall risk-people in the lowest and the highest exercise tertiles were at greater risk. In those with impaired balance, different risk factors predicted greater fall risk-poor executive function, poor dynamic balance, and low exercise levels. Absolute risks for falls ranged from 11\% in those with no risk factors to 54\% in the highest-risk group.
CONCLUSIONS: A classification and regression tree approach highlighted interrelationships and discriminatory value of important explanatory fall risk factors. The information may prove useful in clinical settings to assist in tailoring interventions to maximize the potential benefit of falls prevention strategies.},
  author       = {Delbaere, Kim and Close, Jacqueline CT and Heim, J{\"o}rg and Sachdev, Perminder S and Brodaty, Henry and Slavin, Melissa J and Kochan, Nicole A and Lord, Stephen R},
  issn         = {0002-8614},
  journal      = {JOURNAL OF THE AMERICAN GERIATRICS SOCIETY},
  keyword      = {WOMEN,VALIDATION,AGE,PREVENTION,ADULTS,CLASSIFICATION TREE,RANDOMIZED CONTROLLED-TRIAL,decision tree,Trails B,depression,activities of daily life,aged,accidental falls,DEPRESSION,HEALTH,EXERCISE},
  language     = {eng},
  number       = {9},
  pages        = {1679--1685},
  title        = {A multifactorial approach for understanding fall risk in older people},
  url          = {http://dx.doi.org/10.1111/j.1532-5415.2010.03017.x},
  volume       = {58},
  year         = {2010},
}

Chicago
Delbaere, Kim, Jacqueline CT Close, Jörg Heim, Perminder S Sachdev, Henry Brodaty, Melissa J Slavin, Nicole A Kochan, and Stephen R Lord. 2010. “A Multifactorial Approach for Understanding Fall Risk in Older People.” Journal of the American Geriatrics Society 58 (9): 1679–1685.
APA
Delbaere, K., Close, J. C., Heim, J., Sachdev, P. S., Brodaty, H., Slavin, M. J., Kochan, N. A., et al. (2010). A multifactorial approach for understanding fall risk in older people. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 58(9), 1679–1685.
Vancouver
1.
Delbaere K, Close JC, Heim J, Sachdev PS, Brodaty H, Slavin MJ, et al. A multifactorial approach for understanding fall risk in older people. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY. 2010;58(9):1679–85.
MLA
Delbaere, Kim, Jacqueline CT Close, Jörg Heim, et al. “A Multifactorial Approach for Understanding Fall Risk in Older People.” JOURNAL OF THE AMERICAN GERIATRICS SOCIETY 58.9 (2010): 1679–1685. Print.