Predictive Performance of the FIF Screening Tool in 2 Cohorts of Community-Living Older Adults
(2020) In Journal of the American Medical Directors Association 21(12). p.1-1905- Abstract
Objectives: The First-time Injurious Fall (FIF) screening tool was created to identify fall risk in community-living older adults who may benefit from primary preventive interventions. The aim of this study was to evaluate the predictive performance of the FIF tool in 2 cohorts of older adults. Design: Longitudinal cohort study. Setting and Participants: The Swedish National Study on Aging and Care in Skåne (SNAC-S) and Blekinge (SNAC-B), Sweden. Community-living people aged ≥60 years (n = 2766). Methods: Nurses and physicians collected data in the 2 cohorts through interviews and testing. Data on injurious falls were collected from register data and were defined as receipt of care after a fall. The FIF tool, consisting of 3 questions... (More)
Objectives: The First-time Injurious Fall (FIF) screening tool was created to identify fall risk in community-living older adults who may benefit from primary preventive interventions. The aim of this study was to evaluate the predictive performance of the FIF tool in 2 cohorts of older adults. Design: Longitudinal cohort study. Setting and Participants: The Swedish National Study on Aging and Care in Skåne (SNAC-S) and Blekinge (SNAC-B), Sweden. Community-living people aged ≥60 years (n = 2766). Methods: Nurses and physicians collected data in the 2 cohorts through interviews and testing. Data on injurious falls were collected from register data and were defined as receipt of care after a fall. The FIF tool, consisting of 3 questions and 1 balance test, was examined in relation to injurious falls for up to 5 years of follow-up using Cox proportional hazards models. The predictive performance of the FIF tool was further explored using Harrell C statistic and Youden cut-off for sensitivity and specificity. Results: The hazard ratios (HRs) of an injurious fall in the high-risk group for women and men were 3.80 (95% confidence interval [CI] 2.53, 5.73) and 5.10 (95% CI 2.57, 10.12) in SNAC-S and 4.45 (95% CI 1.86, 10.61) and 32.58 (95% CI 4.30, 247.05) in SNAC-B compared with those in the low risk group. The sensitivity and specificity of the Youden cut-off point (3 or higher for high-risk) were 0.64 and 0.69 for women and 0.68 and 0.69 for men in SNAC-S, and 0.64 and 0.74 for women and 0.94 and 0.68 for men in SNAC-B. The predictive values (Harrell C statistic) for the scores for women and men were 0.73 and 0.74 in SNAC-S and 0.72 and 0.89 in SNAC-B. Conclusions and Implications: Our results suggest that the FIF tool is a valid tool to use for prediction of first-time injurious falls in community-living older adults.
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- author
- Frisendahl, Nathalie ; Ek, Stina LU ; Rosendahl, Erik ; Boström, Anne Marie ; Fagerström, Cecilia LU ; Elmståhl, Sölve LU and Welmer, Anna Karin
- organization
- publishing date
- 2020-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- falls, Injury, older adults, screening tool, validation
- in
- Journal of the American Medical Directors Association
- volume
- 21
- issue
- 12
- pages
- 1 - 1905
- publisher
- Elsevier
- external identifiers
-
- scopus:85086656421
- pmid:32565276
- ISSN
- 1525-8610
- DOI
- 10.1016/j.jamda.2020.04.037
- language
- English
- LU publication?
- yes
- id
- dad72731-91bc-4c2b-9e8c-03ba6298f52a
- date added to LUP
- 2021-01-11 10:12:57
- date last changed
- 2023-11-20 20:04:43
@article{dad72731-91bc-4c2b-9e8c-03ba6298f52a,
abstract = {{<p>Objectives: The First-time Injurious Fall (FIF) screening tool was created to identify fall risk in community-living older adults who may benefit from primary preventive interventions. The aim of this study was to evaluate the predictive performance of the FIF tool in 2 cohorts of older adults. Design: Longitudinal cohort study. Setting and Participants: The Swedish National Study on Aging and Care in Skåne (SNAC-S) and Blekinge (SNAC-B), Sweden. Community-living people aged ≥60 years (n = 2766). Methods: Nurses and physicians collected data in the 2 cohorts through interviews and testing. Data on injurious falls were collected from register data and were defined as receipt of care after a fall. The FIF tool, consisting of 3 questions and 1 balance test, was examined in relation to injurious falls for up to 5 years of follow-up using Cox proportional hazards models. The predictive performance of the FIF tool was further explored using Harrell C statistic and Youden cut-off for sensitivity and specificity. Results: The hazard ratios (HRs) of an injurious fall in the high-risk group for women and men were 3.80 (95% confidence interval [CI] 2.53, 5.73) and 5.10 (95% CI 2.57, 10.12) in SNAC-S and 4.45 (95% CI 1.86, 10.61) and 32.58 (95% CI 4.30, 247.05) in SNAC-B compared with those in the low risk group. The sensitivity and specificity of the Youden cut-off point (3 or higher for high-risk) were 0.64 and 0.69 for women and 0.68 and 0.69 for men in SNAC-S, and 0.64 and 0.74 for women and 0.94 and 0.68 for men in SNAC-B. The predictive values (Harrell C statistic) for the scores for women and men were 0.73 and 0.74 in SNAC-S and 0.72 and 0.89 in SNAC-B. Conclusions and Implications: Our results suggest that the FIF tool is a valid tool to use for prediction of first-time injurious falls in community-living older adults.</p>}},
author = {{Frisendahl, Nathalie and Ek, Stina and Rosendahl, Erik and Boström, Anne Marie and Fagerström, Cecilia and Elmståhl, Sölve and Welmer, Anna Karin}},
issn = {{1525-8610}},
keywords = {{falls; Injury; older adults; screening tool; validation}},
language = {{eng}},
number = {{12}},
pages = {{1--1905}},
publisher = {{Elsevier}},
series = {{Journal of the American Medical Directors Association}},
title = {{Predictive Performance of the FIF Screening Tool in 2 Cohorts of Community-Living Older Adults}},
url = {{http://dx.doi.org/10.1016/j.jamda.2020.04.037}},
doi = {{10.1016/j.jamda.2020.04.037}},
volume = {{21}},
year = {{2020}},
}