Which Method of Fall Ascertainment Captures the Most Falls in Prefrail and Frail Seniors?

Autor: Teister CJ; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Chocano-Bedoya PO; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Orav EJ; Division of General Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts., Dawson-Hughes B; Bone Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, Massachusetts., Meyer U; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Meyer OW; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Freystaetter G; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Gagesch M; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Rizzoli R; Bone Disease Service, University Hospitals of Geneva, Geneva, Switzerland., Egli A; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Theiler R; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland., Kanis JA; Institute of Health and Ageing, Catholic University of Australia, Melbourne, Victoria, Australia.; Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, United Kingdom., Bischoff-Ferrari HA; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Geriatrics and Ageing Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.; University Clinic for Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: American journal of epidemiology [Am J Epidemiol] 2018 Oct 01; Vol. 187 (10), pp. 2243-2251.
DOI: 10.1093/aje/kwy113
Abstrakt: There is no consensus on the most reliable method of ascertaining falls among the elderly. Therefore, we investigated which method captured the most falls among prefrail and frail seniors from 2 randomized controlled trials conducted in Zurich, Switzerland: an 18-month trial (2009-2010) including 200 community-dwelling prefrail seniors with a prior fall and a 12-month trial (2005-2008) including 173 frail seniors with acute hip fracture. Both trials included the same methods of fall ascertainment: monthly active asking, daily self-report diary entries, and a call-in hotline. We compared numbers of falls reported and estimated overall and positive percent agreement between methods. Prefrail seniors reported 499 falls (fall rate = 2.5/year) and frail seniors reported 205 falls (fall rate = 1.4/year). Most falls (81% of falls in prefrail seniors and 78% in frail seniors) were reported via active asking. Among prefrail seniors, diaries captured an additional 19% of falls, while the hotline added none. Among frail seniors, the hotline added 16% of falls, while diaries added 6%. The positive percent agreement between active asking and diary entries was 100% among prefrail seniors and 88% among frail seniors. While monthly active asking captures most falls in both groups, this method alone missed 19% of falls in prefrail seniors and 22% in frail seniors. Thus, a combination of active asking and diaries for prefrail seniors and a combination of active asking and a hotline for frail seniors is warranted.
Databáze: MEDLINE