Abstract
Background and Purpose: Falls are the leading cause of accidental death among older adults. Reducing falls risk is one of the major safety concerns for older persons. More than one-third of people 65 years and older will experience one or more falls per year and nearly half of the people over 80 years of age will fall at least once each year. A key initial step in reducing falls is identifying those persons at highest risk so that they can be assessed and prescribed appropriate interventions. Therefore, the purpose of this study was to examine the capacity of a number of field and laboratory tests to identify fallers in a sample of older independently-living, community-dwelling persons. Participants: 66 healthy, independently living older persons, ages 60 and older. Method: During three visits to the laboratory, participants performed various field and laboratory balance tests. Field tests included the Timed Up and Go Test (TUG), the One-Leg Stand Test (OLS), the Functional Reach Test (FR), and the Tinetti Performance Oriented Mobility Assessment (POMA). The laboratory tests included a center of pressure (COP) test with time-to-boundary (TTB) measurements on a force platform, and dynamic posturography using the Proprio 5000. Each participant was classified as a "faller" or "non-faller" based on whether he or she recalled experiencing a fall within the past year. Results: Receiver-operated characteristics (ROC) curve analyses (specificity and sensitivity throughout the measurement ranges) revealed the OLS and TUG field tests and selected Proprio 5000 and TTB variables had the best capacity to distinguish fallers from non-fallers. For both field and laboratory tests one-way ANOVA revealed between-group differences similar to those indicated by the ROC results. Discussion and Conclusion: Both selected field and laboratory tests could identify fallers (16 out of 66). In addition, the laboratory tests revealed balance decrements in specific planes of motion that provide information concerning directional falls risk and a offer a framework for the prescription of interventions to reduce that risk.