Fall risk question-based tools for fall screening in community-dwelling older adults: a systematic review of the literature

Journal of Frailty, Sarcopenia and Falls, 2023 · DOI: 10.22540/JFSF-08-240 · Published: December 1, 2023

Simple Explanation

Falls are a significant public health concern, particularly for older adults, leading to injuries, hospitalizations, and substantial economic burden. Clinical guidelines suggest using questionnaires and performance-based tools to assess fall risk; however, detailed assessments can be time-consuming and require trained personnel. This study systematically reviews question-based tools for fall risk assessment in older adults to identify the risk factors covered by these tools.

Study Duration

Follow-up period from 3 months to 3 years

Participants

Community-dwelling older adults over the age of 60

Evidence Level

Systematic Review

Key Findings

1
Twenty studies using 22 question-based tools were identified, with the number of questions varying from 1 to 41.
2
Commonly reported fall risk factors include fall history, feeling of unsteadiness, fear of falling, muscle strength, gait limitation, and incontinence.
3
Data quality varied greatly among the studies, and individuals with cognitive impairment were under-represented or excluded from most existing studies.

Research Summary

This systematic review identifies and evaluates question-based tools used to assess fall risk in community-dwelling older adults. The review highlights the heterogeneity in study objectives, including adaptations of existing tools, validation studies, and preliminary questionnaire development. The study emphasizes the need for caution when using these tools, considering their limitations, and calls for further research on high-risk individuals, such as those with cognitive impairment.

Practical Implications

Clinical Practice

Healthcare providers should cautiously use fall risk assessment tools, being mindful of their limitations and the specific populations they were designed for.

Research

Future studies should focus on including under-represented populations, such as individuals with cognitive impairment, to develop more comprehensive fall risk assessment tools.

Tool Development

New tools should aim for a balance between brevity and comprehensiveness, incorporating both intrinsic and extrinsic risk factors to facilitate personalized interventions.

Study Limitations

1
Heterogeneity in study objectives and tool designs.
2
Varied data quality and risk of bias among included studies.
3
Under-representation of men and individuals with cognitive impairment in the study samples.

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