How Well Do Functional Assessments of Mobility and Balance Discriminate Fallers and Recurrent Fallers from Non-Fallers among Ambulatory Older Adults in the Community?

Abstract

Purpose: 1) To compare the ability of functional mobility and balance assessments in discriminating fallers from non-fallers and recurrent fallers from those with fewer or no falls. 2) To compare the discriminatory accuracy of cut-off scores specific to this study sample with that of cut-off scores proposed in the literature for community-dwelling older adults. Methods: In a sample of 39 ambulatory older adults living independently in the community, fallers were identified on the basis of number of falls in the past year. Seven functional tests of mobility and balance were used to identify fallers and recurrent fallers on the basis of their fall history. Results: Discrimination of fallers from non-fallers was poor: Only a high-level balance assessment significantly discriminated these groups (p=0.0498, area under the curve [AUC]=0.68). Four assessments significantly discriminated recurrent fallers from those with fewer or no falls (ps=0.006–0.009), but their discriminatory powers were not significantly different from one another (AUCs=0.77–0.80, p>0.05). For two assessments, cutoff scores based on the study sample enhanced discriminatory accuracy relative to the literature-based cutoff scores. Conclusions: To improve fall prediction for ambulatory community-dwelling older adults, future prospective studies should consider including high-level mobility and balance assessments and targeting cutoff scores to the level of function of this relatively high-functioning population.