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Tools for assessing fall risk in the elderly: a systematic review and meta-analysis

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Abstract

The prevention of falls among the elderly is arguably one of the most important public health issues in today’s aging society. The aim of this study was to assess which tools best predict the risk of falls in the elderly. Electronic searches were performed using Medline, EMBASE, the Cochrane Library, CINAHL, etc., using the following keywords: “fall risk assessment”, “elderly fall screening”, and “elderly mobility scale”. The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Selected studies were meta-analyzed with MetaDisc 1.4. A total of 33 studies were eligible out of the 2,321 studies retrieved from selected databases. Twenty-six assessment tools for fall risk were used in the selected articles, and they tended to vary based on the setting. The fall risk assessment tools currently used for the elderly did not show sufficiently high predictive validity for differentiating high and low fall risks. The Berg Balance scale and Mobility Interaction Fall chart showed stable and high specificity, while the Downton Fall Risk Index, Hendrich II Fall Risk Model, St. Thomas’s Risk Assessment Tool in Falling elderly inpatients, Timed Up and Go test, and Tinetti Balance scale showed the opposite results. We concluded that rather than a single measure, two assessment tools used together would better evaluate the characteristics of falls by the elderly that can occur due to a multitude of factors and maximize the advantages of each for predicting the occurrence of falls.

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Acknowledgements

The author thanks Dr. Jeong-Hae Hwang and Dr. Yun-Kyung Choi for the assistance and advice during data selection, extraction, and the quality assessment of the studies.

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Correspondence to Seong-Hi Park.

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This work was supported by the Soonchunhyang University Research Fund (No. 20150692). The funder had no further role in the conduct of the research.

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Park, SH. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging Clin Exp Res 30, 1–16 (2018). https://doi.org/10.1007/s40520-017-0749-0

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