Assessing Recurrent Fall Risk of Community-Dwelling, Frail Older Veterans Using Specific Tests of Mobility and the Physical Performance Test of Function

Abstract

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. Results. 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.