Predictive value of the World falls guidelines algorithm within the AGELESS-MELoR cohort.

Autor: Lee SJS; Department of Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia., Tan MP; Department of Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia; Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway 47500 Petaling Jaya, Selangor, Malaysia., Mat S; Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia 50300 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia., Singh DKA; Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia 50300 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia., Saedon N; Department of Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia., Aravindhan K; Department of Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia., Xu XJ; Department of Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia., Ramasamy K; Faculty of Pharmacy, Universiti Teknologi MARA(UiTM) Cawangan Selangor, Kampus Puncak Alam 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia., Majeed ABA; Faculty of Pharmacy, Universiti Teknologi MARA(UiTM) Cawangan Selangor, Kampus Puncak Alam 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia., Khor HM; Department of Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia. Electronic address: hmkhor@um.edu.my.
Jazyk: angličtina
Zdroj: Archives of gerontology and geriatrics [Arch Gerontol Geriatr] 2024 Oct; Vol. 125, pp. 105523. Date of Electronic Publication: 2024 Jun 06.
DOI: 10.1016/j.archger.2024.105523
Abstrakt: Aim: The World Falls Guidelines (WFG) Task Force published a falls risk stratification algorithm in 2022. However, its adaptability is uncertain in low- and middle-income settings such as Malaysia due to different risk factors and limited resources. We evaluated the effectiveness of the WFG risk stratification algorithm in predicting falls among community-dwelling older adults in Malaysia.
Methods: Data from the Malaysian Elders Longitudinal Research subset of the Transforming Cognitive Frailty into Later-Life Self-Sufficiency cohort study was utilized. From 2013-2015, participants aged ≥55 years were selected from the electoral rolls of three parliamentary constituencies in Klang Valley. Risk categorisation was performed using baseline data. Falls prediction values were determined using follow-up data from wave 2 (2015-2016), wave 3 (2019) and wave 4 (2020-2022).
Results: Of 1,548 individuals recruited, 737 were interviewed at wave 2, 858 at wave 3, and 742 at wave 4. Falls were reported by 13.4 %, 29.8 % and 42.9 % of the low-, intermediate- and high-risk groups at wave 2, 19.4 %, 25.5 % and 32.8 % at wave 3, and 25.8 %, 27.7 % and 27.0 % at wave 4, respectively. At wave 2, the algorithm generated a sensitivity of 51.3 % (95 %CI, 43.1-59.2) and specificity of 80.1 % (95 %CI, 76.6-83.2). At wave 3, sensitivity was 29.4 % (95 %CI, 23.1-36.6) and specificity was 81.6 % (95 %CI, 78.5-84.5). At wave 4, sensitivity was 26.0 % (95 %CI, 20.2-32.8) and specificity was 78.4 % (95 %CI, 74.7-81.8).
Conclusion: The algorithm has high specificity and low sensitivity in predicting falls, with decreasing sensitivity over time. Therefore, regular reassessments should be made to identify individuals at risk of falling.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: M.P.T. was a co-author of the World Falls Guidelines publication in 2022 (https://doi.org/10.1093/ageing/afac205). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
Externí odkaz: