Does misjudgement in a stepping down paradigm predict falls in an older population?

Area of Science:

• Gerontology
• Biomechanics
• Clinical Psychology

Background:

• Falls in older adults are a significant public health concern.
• Actual physical ability and perceived physical ability are known fall predictors.
• A disparity between actual and perceived ability (misjudgement) may offer further predictive insight.

Purpose of the Study:

• To investigate if incorporating a misjudgement term enhances the prediction of future falls in older adults.
• To assess the predictive value of a behavioural misjudgement measure derived from a stepping-down task.

Main Methods:

• A sample of 55 older adults (mean age 74.5 years) was studied over 10 months.
• Conventional measures included physical assessments and questionnaires (Falls Efficacy Scale international, QuickScreen).
• A stepping-down paradigm quantified behavioural misjudgement; Bayesian logistic regression models were used for analysis.

Main Results:

• The default model using conventional measures showed the most accurate fit, but overall model accuracy was low (ROC ≤ 0.65).
• Adding a misjudgement term, whether from conventional or behavioural measures, did not improve fall prediction.
• Bayes Factor (BF10) indicated no substantial evidence for improved prediction with misjudgement terms (BF10 ≤ 0.5).

Conclusions:

• Neither conventional nor behavioural misjudgement measures significantly improved the prediction of future falls in this cohort of older adults.
• Current methods for assessing physical ability and perceived confidence, including misjudgement, have limitations in predicting falls.
• Further research is needed to identify more effective predictors of falls in aging populations.