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How accurate are geriatricians' fall predictions?

Jason Wilbur1, Gerald Jogerst2, Nicholas Butler2

  • 1Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA. jason-wilbur@uiowa.edu.

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|May 18, 2022
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Summary

Geriatricians showed moderate agreement in predicting falls among older adults, with accuracy comparable to standard screening tools. Further research is needed to compare their predictive abilities against established fall risk assessments.

Keywords:
Fall riskOlder adultsPredictionScreening

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Area of Science:

  • Gerontology
  • Clinical Geriatrics
  • Fall Prevention Research

Background:

  • Older adults face significant risks of falls, leading to severe morbidity and mortality.
  • Accurate identification of high-risk individuals enables targeted interventions to mitigate fall-related adverse outcomes.
  • Geriatricians possess specialized training for assessing fall risk, but their predictive accuracy is not well-established.

Purpose of the Study:

  • To evaluate the accuracy of geriatricians in predicting falls among older patients.
  • To compare geriatrician fall risk predictions with actual fall outcomes and standardized assessment tools.

Main Methods:

  • 100 older adults from a geriatric clinic underwent gait/balance assessments and completed questionnaires.
  • Five geriatricians, blinded to fall outcomes, predicted faller status based on provided subject data.
  • Predictions were compared against an examining geriatrician's assessment and self-reported fall incidence over 6-12 months.

Main Results:

  • Geriatricians demonstrated moderate agreement (Kappa 0.42-0.59) when classifying fallers versus non-fallers.
  • The mean accuracy of geriatrician fall prediction was 67.4%, closely aligning with the mean accuracy of screening tools (66.6%).

Conclusions:

  • This study contributes limited data on geriatrician fall prediction accuracy in older adults.
  • Further research is essential to compare geriatrician assessments with standardized fall risk assessment tools.