Fall risk assessment tools for use among older adults in long-term care settings: A systematic review of the literature

Australas J Ageing. 2018 Mar;37(1):23-33. doi: 10.1111/ajag.12476. Epub 2017 Nov 23.

Abstract

Objective: To conduct a systematic review of published fall risk assessment tools (FRATs) tested for predictive validity among older adults in long-term care (LTC).

Methods: A systematic search was conducted using five databases. Only studies reporting on sensitivity and specificity values, conducted in LTC on populations primarily aged over 60 years, were considered.

Results: Fifteen papers were included and three different categories of FRATs emerged: multifactorial assessment tools, functional mobility assessments and algorithms. Several FRATs showed moderate-to-good predictive validity and reliability, with the Modified Fall Assessment Tool and the Peninsula Health Falls Risk Assessment Tool (PHFRAT) also demonstrating good feasibility.

Conclusion: Evidence for the best choice of FRAT for use in LTC remains limited. Further research is warranted for the PHFRAT, recommended for use in LTC by best practice guidelines, before its establishment as the tool of choice for these clinical settings.

Keywords: falls; frail elderly; long-term care; risk assessment; sensitivity and specificity.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Decision Support Techniques*
  • Female
  • Geriatric Assessment
  • Homes for the Aged*
  • Humans
  • Long-Term Care*
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Patient Safety
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors