Age and Ageing Advance Access published online on February 10, 2007
Age and Ageing, doi:10.1093/ageing/afl165
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Systematic Review |
Multifactorial and functional mobility assessment tools for fall risk among older adults in community, home-support, long-term and acute care settings
1 British Columbia Injury Research & Prevention Unit and Ministry of Health, Office for Injury Prevention, 1515 Blanshard, Victoria, BC, V8W 3C8, Canada
2 Centre on Aging, University of Victoria, STN CSC, Victoria, BC, V8W 2Y2, Canada
3 Health Research Consultant, 1227 Rockland Avenue, Victoria BC, V8V 3J1, Canada
4 Prince of Wales Medical Research Institute, Barker Street, Randwick, Sydney, NSW 2031, Australia
Address correspondence to: Vicky Scott. Tel: (250) 952-1520; Fax: (250) 952-2072. Email: vicky.scott{at}gov.bc.ca
Objective: to conduct a systematic review of published studies that test the validity and reliability of fall-risk assessment tools for use among older adults in community, home-support, long-term and acute care settings.
Methods: searches were conducted in EbscoHost and MEDLINE for published studies in the English language between January 1980 and July 2004, where the primary or secondary purpose was to test the predictive value of one or more fall assessment tools on a population primarily 65 years and older. The tool must have had as its primary outcome falls, fall-related injury or gait/balance. Only studies that used prospective validation were considered.
Findings: thirty-four articles testing 38 different tools met the inclusion criteria. The community setting represents the largest number of studies (14) and tools (23) tested, followed by acute (12 studies and 8 tools), long-term care (LTC) (6 studies and 10 tools) and home-support (4 studies and 4 tools). Eleven of the 38 tools are multifactorial assessment tools (MAT) that cover a wide range of fall-risk factors, and 27 are functional mobility assessment tools (FMA) that involve measures of physical activity related to gait, strength or balance.
Conclusion: fall-risk assessment tools exist that show moderate to good validity and reliability in most health service delivery areas. However, few tools were tested more than once or in more than one setting. Therefore, no single tool can be recommended for implementation in all settings or for all subpopulations within each setting.
Keywords: fall-risk assessment, older adults, systematic review, predictive value, elderly, systematic review
Received 2 December 2005; accepted in revised form 22 October 2006.
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