TY  - JOUR
PY  - 2016//
TI  - Predictive performance of a Fall Risk Assessment Tool (FRAT-up) for community-dwelling older people in 4 European cohorts
JO  - Journal of the American Medical Directors Association
A1  - Palumbo, Pierpaolo
A1  - Klenk, Jochen
A1  - Cattelani, Luca
A1  - Bandinelli, Stefania
A1  - Ferrucci, Luigi
A1  - Rapp, Kilian
A1  - Chiari, Lorenzo
A1  - Rothenbacher, Dietrich
SP  - 1106
EP  - 1113
VL  - 17
IS  - 12
N2  - BACKGROUND AND OBJECTIVE: The fall risk assessment tool (FRAT-up) is a tool for predicting falls in community-dwelling older people based on a meta-analysis of fall risk factors. Based on the fall risk factor profile, this tool calculates the individual risk of falling over the next year. The objective of this study is to evaluate the performance of FRAT-up in predicting future falls in multiple cohorts. <br><br>METHODS: Information about fall risk factors in 4 European cohorts of older people [Activity and Function in the Elderly (ActiFE), Germany; English Longitudinal Study of Aging (ELSA), England; Invecchiare nel Chianti (InCHIANTI), Italy; Irish Longitudinal Study on Aging (TILDA), Ireland] was used to calculate the FRAT-up risk score in individual participants. Information about falls that occurred after the assessment of the risk factors was collected from subsequent longitudinal follow-ups. We compared the performance of FRAT-up against those of other prediction models specifically fitted in each cohort by calculation of the area under the receiver operating characteristic curve (AUC). <br><br>RESULTS: The AUC attained by FRAT-up is 0.562 [95% confidence interval (CI) 0.530-0.594] for ActiFE, 0.699 (95% CI 0.680-0.718) for ELSA, 0.636 (95% CI 0.594-0.681) for InCHIANTI, and 0.685 (95% CI 0.660-0.709) for TILDA. Mean FRAT-up AUC as estimated from meta-analysis is 0.646 (95% CI 0.584-0.708), with substantial heterogeneity between studies. In each cohort, FRAT-up discriminant ability is surpassed, at most, by the cohort-specific risk model fitted on that same cohort. <br><br>CONCLUSIONS: We conclude that FRAT-up is a valid approach to estimate risk of falls in populations of community-dwelling older people. However, further studies should be performed to better understand the reasons for the observed heterogeneity across studies and to refine a tool that performs homogeneously with higher accuracy measures across different populations.<br><br>Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1525-8610
UR  - http://dx.doi.org/10.1016/j.jamda.2016.07.015
ID  - ref1
ER  -