Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 53, Issue 6 M457-M464, Copyright © 1998 by The Gerontological Society of America
Assessing recurrent fall risk of community-dwelling, frail older veterans using specific tests of mobility and the physical performance test of function
JM VanSwearingen, KA Paschal, P Bonino and TW Chen
School of Health and Rehabilitation Sciences, University of Pittsburgh, PA 15260, USA.
BACKGROUND: The purpose of this prospective cohort study was to determine
if older individuals at risk for recurrent falls are best identified by
mobility or functional assessments. METHODS: Eighty-four
community-dwelling, frail male veterans, mean age of 75.5 years (SD=7.33),
participated. The history of recurrent falls was determined by self or
proxy report in a clinical interview. Mobility assessments included the
Modified Gait Abnormality Rating Scale (GARS-M), stride length, and walking
velocity; functional performance was determined using the Physical
Performance Test (PPT). The clinical usefulness of the measures was
described by determining the sensitivity and specificity of each measure
using the history of recurrent falls as a standard. RESULT: Stepwise
logistic regression analysis of the data indicated that the GARS-M (p <
.01) and the PPT (p < .01) were the most important predictors of
recurrent fall risk. The sensitivity and specificity of the measures used
were: GARS-M, 62.3% and 87.1%; PPT, 79.3% and 71.0%; walking speed, 71.7%
and 74.2%; and stride length, 63.2% and 77.4%. Together the GARS-M and PPT
demonstrated the highest sensitivity of 90.6% and the highest specificity
of 87. 1% based on a subject testing positive on at least one test.
CONCLUSION: Used independently and in combination, the GARS-M and the PPT
were clinically useful measures in screening for older individuals at risk
for recurrent falls.
