Article type
Abstract
Abstract
Background: Falls are a fundamental safety concern in older people living in nursing homes, and the assessment of fall risk is critical for the success of fall prevention interventions. There are currently many fall risk assessment tools available, but which tool can best predict the fall risk is still unclear.
Objective: The aim of this study was to assess which fall risk assessment tools best predict the risk of falls among older adults living in nursing homes.
Methods: Searches were performed across 5 Chinese and 9 English databases systematically from inception to December 2023. Diagnostic studies, written in English or Chinese were included. Two independent reviewers evaluated all relevant studies, who also assessed the risk of bias, and extracted the data. Meta-analyses were conducted using MetaDisc 1.4.
Results: A total of 26 studies were eligible out of the 7107 studies retrieved from selected databases. We performed a meta-analysis on 18 studies with 19 fall risk assessment tools. 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 St. Thomas’s Risk Assessment Tool in Falling elderly inpatients, Modified Fall Assessment Tool, Mobility Interaction Fall, and Modified Get-Up-and-Go Test showed stable and high specificity, while the Peninsula Health Falls Risk Assessment Tool, Screening model for falls in residents who could stand unaided, Toulouse-St. Louis University Mini Falls Assessment , and Timed Up-and-Go Test showed the opposite results.
Conclusions: There is still a lack of evidence supporting the ideal falls risk assessment instrument for use among older adults living in nursing homes. We recommend two assessment tools used together to 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.
Background: Falls are a fundamental safety concern in older people living in nursing homes, and the assessment of fall risk is critical for the success of fall prevention interventions. There are currently many fall risk assessment tools available, but which tool can best predict the fall risk is still unclear.
Objective: The aim of this study was to assess which fall risk assessment tools best predict the risk of falls among older adults living in nursing homes.
Methods: Searches were performed across 5 Chinese and 9 English databases systematically from inception to December 2023. Diagnostic studies, written in English or Chinese were included. Two independent reviewers evaluated all relevant studies, who also assessed the risk of bias, and extracted the data. Meta-analyses were conducted using MetaDisc 1.4.
Results: A total of 26 studies were eligible out of the 7107 studies retrieved from selected databases. We performed a meta-analysis on 18 studies with 19 fall risk assessment tools. 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 St. Thomas’s Risk Assessment Tool in Falling elderly inpatients, Modified Fall Assessment Tool, Mobility Interaction Fall, and Modified Get-Up-and-Go Test showed stable and high specificity, while the Peninsula Health Falls Risk Assessment Tool, Screening model for falls in residents who could stand unaided, Toulouse-St. Louis University Mini Falls Assessment , and Timed Up-and-Go Test showed the opposite results.
Conclusions: There is still a lack of evidence supporting the ideal falls risk assessment instrument for use among older adults living in nursing homes. We recommend two assessment tools used together to 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.