The INITIATE (Initial Test for Fall Risk Assessment in the Elderly) prospective cohort study: baseline results

Area of Science:

• Gerontology
• Biomedical Engineering
• Public Health

Background:

• Fall prevention strategies for older adults rely on mobility and balance testing.
• Current guidelines lack consensus on optimal tests and cut-off values for identifying high fall risk.
• The INITIATE study aims to identify the best screening tests for predicting falls in community-dwelling older adults.

Purpose of the Study:

• To determine the optimal screening test(s) for predicting falls among community-dwelling older adults.
• To describe the protocol, sample characteristics, and baseline differences between fallers and non-fallers in the INITIATE study.

Main Methods:

• A 1-year prospective cohort study involving community-dwelling older adults (≥65 years).
• Administered 7 validated balance and mobility tests at a baseline visit.
• Tracked falls over 12 months using monthly diaries and follow-up calls.

Main Results:

• 514 participants (19% consent rate) were enrolled, with a mean age of 76.4 years; 45% reported a fall in the past year.
• Significant differences (p < 0.05) were observed in all 7 balance and mobility tests between baseline fallers and non-fallers.
• No demographic differences (age, sex, income, education) were found between fallers and non-fallers.

Conclusions:

• Baseline differences in balance and mobility tests between fallers and non-fallers warrant further investigation.
• Prospective comparisons are needed to establish the predictive validity of these tests.
• Future results will inform updates to fall risk assessment and prevention guidelines.