Article

Screening should have simple and easy-to-administer methods that identify impairments associated with future fall risk, but there is a lack of literature supporting validation for their use. The aim of this study
was to evaluate the independent contribution of balance assessment on future fall
risk, using 5 methods to quantify balance impairment, for the outcomes "any fall"
and "any injurious fall" in community-dwelling older adults who are higher
functioning. DESIGN: This was a prospective cohort study. METHODS: A sample of
210 community-dwelling older adults (70% male, 30% female; mean age=79.9 years,
SD=4.7) received a comprehensive geriatric assessment at baseline, which included
the Berg Balance Scale to measure balance. Information on daily falls was
collected for 12 months by each participant's monthly submission of a falls log
calendar. RESULTS: Seventy-eight people (43%) fell, of whom 54 (30%) sustained an
injurious fall and 32 (18%) had recurrent falls (> or =2 falls). Different
balance measurement methods identified different numbers of people as impaired.
Adjusted relative risk (RR) estimates for an increased risk of any fall were 1.58
(95% confidence interval [CI]=1.06, 2.35) for self-report of balance problems,
1.58 (95% CI=1.03, 2.41) for one-leg stance, and 1.46 (95% CI=1.02, 2.09) for
limits of stability. An adjusted RR estimate for an increased risk of an
injurious fall of 1.95 (95% CI=1.15, 3.31) was found for self-report of balance
problems. Limitations The study was a secondary analysis of data. CONCLUSIONS:
Not all methods of evaluating balance impairment are associated with falls. The
number of people identified as having balance impairment varies with the
measurement tool; therefore,
the measurement tools are not interchangeable or
equivalent in defining an at-risk population. The thresholds established in this
study indicate individuals who should receive further comprehensive fall
assessment and treatment to prevent falls.

Langue : ANGLAIS