Pieter Boele van Hensbroek1, Nynke van Dijk2, G Fenna van Breda3, Alice C Scheffer3, Tischa J van der Cammen4, Paul Lips5, J Carel Goslings1, Sophia E de Rooij6. 1. Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam. 2. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam. 3. Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam. 4. Department of Geriatric Medicine, Erasmus Medical Center, Rotterdam. 5. Department of Internal Medicine, Free University Medical Center, Amsterdam. 6. Department of Internal Medicine, Section of Geriatrics, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam. Electronic address: s.e.derooij@amc.uva.nl.
Abstract
OBJECTIVE: To validate the CAREFALL Triage Instrument (CTI), a self-administered questionnaire concerning modifiable risk factors for recurrent falls in elderly patients who experienced fall. METHODS: This study in patients 65 years or older who experienced fall was performed at the accident and emergency department of a tertiary university hospital in the Netherlands. The construct validity was determined in 200 patients and 100 matched controls. The test-retest reliability was determined in 27 patients who answered the CTI twice. The clinical validity was determined in 111 high-risk patients who visited the Fall Prevention Clinic (FPC). The risk factors were as follows: medication, balance and mobility, fear of falling, orthostatic hypotension, mood, high risk of osteoporosis, impaired vision, and urinary incontinence. RESULTS: Construct Validity Recurrent falls correlated with more risk factors. Age, female gender, and 6 risk factors correlated with recurrent falls. Clinical validity: the agreement between the CTI and FPC was fair for balance and mobility, orthostatic hypotension, and urinary incontinence, moderate for mood, fear of falling, and high risk of osteoporosis, and substantial for "medication and impaired vision. Test-retest reliability: the agreement between the 2 CTIs was substantial for medication, high risk of osteoporosis, moderate for balance and mobility, mood, fair for orthostatic hypotension, impaired vision, and urinary incontinence, and poor for fear of falling. CONCLUSION: The CTI is reliable and valid in assessing risk factors for recurrent falls in elderly patients who experienced fall.
OBJECTIVE: To validate the CAREFALL Triage Instrument (CTI), a self-administered questionnaire concerning modifiable risk factors for recurrent falls in elderly patients who experienced fall. METHODS: This study in patients 65 years or older who experienced fall was performed at the accident and emergency department of a tertiary university hospital in the Netherlands. The construct validity was determined in 200 patients and 100 matched controls. The test-retest reliability was determined in 27 patients who answered the CTI twice. The clinical validity was determined in 111 high-risk patients who visited the Fall Prevention Clinic (FPC). The risk factors were as follows: medication, balance and mobility, fear of falling, orthostatic hypotension, mood, high risk of osteoporosis, impaired vision, and urinary incontinence. RESULTS: Construct Validity Recurrent falls correlated with more risk factors. Age, female gender, and 6 risk factors correlated with recurrent falls. Clinical validity: the agreement between the CTI and FPC was fair for balance and mobility, orthostatic hypotension, and urinary incontinence, moderate for mood, fear of falling, and high risk of osteoporosis, and substantial for "medication and impaired vision. Test-retest reliability: the agreement between the 2 CTIs was substantial for medication, high risk of osteoporosis, moderate for balance and mobility, mood, fair for orthostatic hypotension, impaired vision, and urinary incontinence, and poor for fear of falling. CONCLUSION: The CTI is reliable and valid in assessing risk factors for recurrent falls in elderly patients who experienced fall.
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