Age and Ageing Advance Access originally published online on April 26, 2006
Age and Ageing 2006 35(4):450-451; doi:10.1093/ageing/afl016
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Falls definition—reliability of patients’ own reports
SIR—Your systematic review of methodology in falls trials [1] highlights the complexity of the definition and identification of falls. If such inconsistency exists even within well-designed and resourced research studies, how much more difficult will it prove to develop effective falls-monitoring procedures for day-to-day use in clinical settings.We have explored the reliability of patients’ own reports as an epidemiological tool. As part of the validation of a study of patients presenting to our Accident and Emergency department, we approached 107 individuals aged over 50 years. Each was initially asked ‘Did you fall?’, and their response was recorded. A detailed history of the events surrounding the fall was then taken.
Mean age was 67.7 (range 50–91) years. Sixty-nine (64.5%) of them were women. Fifty-four patients (50.5%) stated that they had fallen, and on detailed questioning, this appeared consistent with the most widely accepted definitions of falls [2, 3].
Of the 53 patients who did not report a fall, five described a ‘slip’ and one had no clear recollection of events on detailed questioning. Thus, the ‘Did you fall?’ question had a sensitivity of 91.5% and a specificity and positive predictive value of 100% as a tool in the A&E setting.
Existing definitions of a fall are impractical for use by the large numbers of staff from different disciplines who work in this and other clinical settings. A reliance on patient reports in response to the simple ‘Did you fall?’ question appears justified for falls monitoring and similar epidemiological purposes.
Department of Geriatric Medicine, University Hospital of Wales Cardiff, Cardiff CF14 4XW, UK
* To whom correspondence should be addressed at: Email: antony.johansen{at}cardiffandvale.wales.nhs.uk
References
- Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C, PROFANE-Group. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 2006; 35: 5–10.
[Abstract/Free Full Text] - Kellogg International Work Group on the Prevention of Falls in the Elderly. The prevention of falls in later life. Dan Med Bull 1987; 34: 1–24.[Medline]
- Buchner DM, Hornbrook MC, Kutner NG et al. Development of the common database for FICSIT trials. J Am Geriatr Soc 1993; 41: 297–308.[ISI][Medline]
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