Functional Measures for Fall Risk in the Acute Care Setting: A Review

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Patient Safety

Background:

• Falls are a significant concern for older adults in acute care settings, leading to increased morbidity and healthcare costs.
• Effective screening for fall risk is crucial for implementing timely preventive interventions.

Purpose of the Study:

• To review the evidence on functional ability measures for fall risk assessment in hospitalized older adults (≥55 years).
• To identify feasible and effective measures for use in the acute care environment.

Main Methods:

• Systematic review of 19 articles from six bibliographic databases.
• Search terms included acute care, inpatient, fall, and fall prevention.
• Analysis focused on clinical performance (sensitivity, specificity) of functional ability measures.

Main Results:

• The Timed Up and Go (TUG) test demonstrated fair sensitivity (56%-68%) and good specificity (74%-80%), indicating feasibility for clinicians.
• Other measures like the Berg Balance Scale and Functional Reach test showed less favorable clinical performance compared to TUG.
• Functional ability measures are currently underutilized in acute care, possibly due to knowledge and training gaps.

Conclusions:

• The TUG test is a recommended functional ability measure for fall risk screening in acute care.
• Improved clinician knowledge and training, alongside combining functional measures with subjective tools, could enhance fall risk identification accuracy.