This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Results of Two Population-Based Studies

Alan S. Robbins, MD; Laurence Z. Rubenstein, MD, MPH; Karen R. Josephson, MPH; Barbara L. Schulman, RN, GNP; Dan Osterweil, MD; Gilbert Fine, MS

Arch Intern Med. 1989;149(7):1628-1633.

Abstract
• A study was performed to identify and rank risk factors for falling among populations of institutionalized (fallers, N=79, nonfallers, N=70) and noninstitutionalized (fallers, N =34, nonfallers, N = 34) elderly persons. Fallers were matched by age, sex, and living location to nonfaller control subjects. A nurse practitioner performed a comprehensive physical assessment in all subjects using a standardized protocol and physician consultation. Fallers in both populations were significantly more physically and functionally impaired than control subjects. Logistic regression identified hip weakness, poor balance, and number of prescribed medications as factors most strongly associated with falling among institutionalized subjects. A fall prediction model was developed from these findings yielding 76% overall predictive accuracy (89% sensitivity, 60% specificity). Using the model, the predicted 1-year risk of falling ranged from 12% for persons with none of the three risk factors to 100% for persons with all three risk factors. Findings among noninstitutionalized subjects were similar. These data support the concept of performing focused fall risk assessments to identify elderly patients at high risk for falling.

(Arch Intern Med. 1989;149:1628-1633)

Author Affiliations
From the Department of Medicine and Geriatric Research Education and Clinical Center, Sepulveda (Calif) Veterans Administration Medical Center (Drs Robbins and Rubenstein, Mss Josephson and Schulman, and Mr Fine); UCLA School of Medicine, Los Angeles, Calif (Drs Robbins, Rubenstein, and Osterweil); and Jewish Homes for the Aging of Greater Los Angeles (Calif) (Drs Rubenstein and Osterweil).

Footnotes
Accepted for publication March 29, 1989.

Presented, in part, at the annual scientific meeting of the American Geriatrics Society, Anaheim, Calif, May 1988.

Reprint requests to Veterans Administration Medical Center (11), Sepulveda, CA 91343 (Dr Robbins).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff's global judgement and fall history in evaluating fall risk in residential care facilities
Nordin et al.
Age Ageing 2008;37:442-448.
ABSTRACT | FULL TEXT  

ASHP Therapeutic Position Statement on the Prevention and Treatment of Osteoporosis in Adults
MacLaughlin and Raehl
Am J Health Syst Pharm 2008;65:343-357.
FULL TEXT  

Practice Parameter: Assessing patients in a neurology practice for risk of falls (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Thurman et al.
Neurology 2008;70:473-479.
ABSTRACT | FULL TEXT  

Repeated-Slip Training: An Emerging Paradigm for Prevention of Slip-Related Falls Among Older Adults
Pai and Bhatt
ptjournal 2007;87:1478-1491.
ABSTRACT | FULL TEXT  

Reliability and Validity of the Tinetti Mobility Test for Individuals With Parkinson Disease
Kegelmeyer et al.
ptjournal 2007;87:1369-1378.
ABSTRACT | FULL TEXT  

Calcaneal bone mineral density in older patients who have fallen.
Newton et al.
QJM 2006;99:231-236.
ABSTRACT | FULL TEXT  

Impact of Falls on the Balance, Gait, and Activities of Daily Living Functioning in Community-Dwelling Chinese Older Adults
Chu et al.
J Gerontol A Biol Sci Med Sci 2006;61:399-404.
ABSTRACT | FULL TEXT  

Focused supervision of high-risk fall dementai patients: A simple method to reduce fall incidence and severity
Detweiler et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2005;20:97-104.
ABSTRACT  

Experimental designs for multicomponent interventions among persons with multifactorial geriatric syndromes
Allore et al.
Clin Trials 2005;2:13-21.
ABSTRACT  

Preventing Falls in the Elderly: The Role of the Pharmacist
Keys and Tress
Journal of Pharmacy Practice 2004;17:149-152.
ABSTRACT  

Guidelines on Management (diagnosis and treatment) of syncope - update 2004: The Task Force on Syncope, European Society of Cardiology
Europace 2004;6:467-537.
FULL TEXT  

A prospective study of the rate of falls before and after cataract surgery
Brannan et al.
Br J Ophthalmol 2003;87:560-562.
ABSTRACT | FULL TEXT  

Fall Risk Assessment Measures: An Analytic Review
Perell et al.
J Gerontol A Biol Sci Med Sci 2001;56:M761-M766.
ABSTRACT | FULL TEXT  

Do the Risks and Consequences of Hospitalized Fall Injuries Among Older Adults in California Vary by Type of Fall?
Ellis and Trent
J Gerontol A Biol Sci Med Sci 2001;56:M686-M692.
ABSTRACT | FULL TEXT  

Quality Indicators for the Management and Prevention of Falls and Mobility Problems in Vulnerable Elders
Rubenstein et al.
ANN INTERN MED 2001;135:686-693.
FULL TEXT  

Guidelines on management (diagnosis and treatment) of syncope
Task Force on Syncope, European Society of Cardiol et al.
Eur Heart J 2001;22:1256-1306.
ABSTRACT  

Tai chi: physiological characteristics and beneficial effects on health
Li et al.
Br. J. Sports. Med. 2001;35:148-156.
ABSTRACT | FULL TEXT  

Making Geriatric Assessment Work: Selecting Useful Measures
VanSwearingen and Brach
ptjournal 2001;81:1233-1252.
ABSTRACT | FULL TEXT  

History and Mobility Exam Index to Identify Community-Dwelling Elderly Persons at Risk of Falling
Covinsky et al.
J Gerontol A Biol Sci Med Sci 2001;56:M253-M259.
ABSTRACT | FULL TEXT  

Managing falls in older people
DTB 2000;38:68-72.
ABSTRACT | FULL TEXT  

Different Method, Different Results?
Irwin et al.
ptjournal 2000;80:622-624.
FULL TEXT  

Lower-Extremity Muscle Force and Balance Performance in Adults Aged 65 Years and Older
Daubney and Culham
ptjournal 1999;79:1177-1185.
ABSTRACT | FULL TEXT  

Mobility Performance in Glaucoma
Turano et al.
IOVS 1999;40:2803-2809.
ABSTRACT | FULL TEXT  

Relationship Between Balance and Abnormalities in Cerebral Magnetic Resonance Imaging in Older Adults
Tell et al.
Arch Neurol 1998;55:73-79.
ABSTRACT | FULL TEXT  

An 85-Year-Old Woman With a History of Falls
Lipsitz
JAMA 1996;276:59-66.
ABSTRACT  

The Effects of Exercise on Falls in Elderly Patients: A Preplanned Meta-analysis of the FICSIT Trials
Province et al.
JAMA 1995;273:1341-1347.
ABSTRACT  

Shared Risk Factors for Falls, Incontinence, and Functional Dependence: Unifying the Approach to Geriatric Syndromes
Tinetti et al.
JAMA 1995;273:1348-1353.
ABSTRACT  

Medications and Chronic Diseases as Risk Factors for Falling Injuries in the Elderly
Ryynanen et al.
Scand J Public Health 1993;21:264-271.
ABSTRACT  

Mechanical Restraint Use and Fall-related Injuries among Residents of Skilled Nursing Facilities
Tinetti et al.
ANN INTERN MED 1992;116:369-374.
ABSTRACT  

The Value of Assessing Falls in an Elderly Population: A Randomized Clinical Trial
Rubenstein et al.
ANN INTERN MED 1990;113:308-316.
ABSTRACT  

Geriatric Medicine
Rubenstein
JAMA 1990;263:2644-2646.
ABSTRACT