The Clinical Potential of Frailty Indicators on Identifying Recurrent Fallers in the Community: The Mr. Os and Ms. OS Cohort Study in Hong Kong.
Freddy M H Lam, Jason C S Leung, Timothy C Y Kwok
PMID 31399362WHAT IT FOUND
Fall history was the strongest predictor of recurrent falls in older adults.
Frailty indicators did not beat it; they added little, mainly in women with a prior fall.
Key findings
01A history of falls predicted recurrent falls better than any frailty indicator in both men and women.
02In older women, FRAIL and SOF remained associated with recurrent falls after adjusting for fall history, but the gain in prediction was only modest.
03Among women with one prior fall, a FRAIL score of one separated a higher-risk group with a 14.9% chance of recurrent falls from a lower-risk group with an 8.5% chance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The number of recurrent fallers was small because the overall fall rate was low. Falls were recalled over one year, which the paper says may underestimate falls by 13%. Only people who could walk independently and attend the center were included, so the sample was healthier than the wider community. Prospective fall data came from 3153 participants, fewer than the 3427 assessed at baseline. Frailty scores were right-skewed, so the association with recurrent falls may be underestimated. Some frailty items used surrogate measures rather than direct measures.
Declared interests
The authors declared no conflicts of interest. The paper lists NIH and non-U.S. government research support.
The easy way to misread this
Do not conclude that frailty screening can replace asking about falls. Fall history had the highest ability to separate recurrent fallers, and frailty indicators did not outperform it.