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Citation
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Forth KE, Wirfel KL, Adams SD, Rianon NJ, Lieberman Aiden E, Madansingh SI. Front. Med. (Lausanne) 2020; 7: e591517. |
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Abstract
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INTRODUCTION: Falls are the leading cause of accidental death in older adults. Each year, 28.7% of US adults over 65 years experience a fall resulting in over 300,000 hip fractures and $50 billion in medical costs. Annual fall risk assessments have become part of the standard care plan for older adults. However, the effectiveness of these assessments in identifying at-risk individuals remains limited. This study characterizes the performance of a commercially available, automated method, for assessing fall risk using machine learning.
METHODS: Participants (N = 209) were recruited from eight senior living facilities and from adults living in the community (five local community centers in Houston, TX) to participate in a 12-month retrospective and a 12-month prospective cohort study. Upon enrollment, each participant stood for 60 s, with eyes open, on a commercial balance measurement platform which uses force-plate technology to capture center-of-pressure (60 Hz frequency). Linear and non-linear components of the center-of-pressure were analyzed using a machine-learning algorithm resulting in a postural stability (PS) score (range 1-10). A higher PS score indicated greater stability. Participants were contacted monthly for a year to track fall events and determine fall circumstances. Reliability among repeated trials, past and future fall prediction, as well as survival analyses, were assessed.
RESULTS: Measurement reliability was found to be high (ICC(2,1) [95% CI]=0.78 [0.76-0.81]). Individuals in the high-risk range (1-3) were three times more likely to fall within a year than those in low-risk (7-10). They were also an order of magnitude more likely (12/104 vs. 1/105) to suffer a spontaneous fall i.e., a fall where no cause was self-reported. Survival analyses suggests a fall event within 9 months (median) for high risk individuals.
CONCLUSIONS: We demonstrate that an easy-to-use, automated method for assessing fall risk can reliably predict falls a year in advance.
OBJECTIVE identification of at-risk patients will aid clinicians in providing individualized fall prevention care.
Language: en |