TY  - JOUR
PY  - 2008//
TI  - Multidimensional geriatric assessment: back to the future preclinical disability as a risk factor for falls in community-dwelling older adults
JO  - Journals of gerontology. Series A: Biological sciences and medical sciences
A1  - Clough-Gorr, Kerri M.
A1  - Erpen, Thomas
A1  - Gillmann, Gerhard
A1  - von Renteln-Kruse, W.
A1  - Iliffe, Steve
A1  - Beck, J. C.
A1  - Stuck, A. E.
SP  - 314
EP  - 320
VL  - 63
IS  - 3
N2  - Background. Falls are common and serious problems in older adults. The goal of this study was to examine whether preclinical disability predicts incident falls in a European population of community-dwelling older adults. Methods. Secondary data analysis was performed on a population-based longitudinal study of 1644 community-dwelling older adults living in London, U.K.; Hamburg, Germany; Solothurn, Switzerland. Data were collected at baseline and 1-year follow-up using a self-administered multidimensional health risk appraisal questionnaire, including validated questions on falls, mobility disability status (high function, preclinical disability, task difficulty), and demographic and health-related characteristics. Associations were evaluated using bivariate and multivariate logistic regression analyses. Results. Overall incidence of falls was 24%, and increased by worsening mobility disability status: high function (17%), preclinical disability (32%), task difficulty (40%), test-of-trend p <.003. In multivariate analysis adjusting for other fall risk factors, preclinical disability (odds ratio [OR] = 1.7, 95% confidence interval [CI], 1.1-2.5), task difficulty (OR = 1.7, 95% CI, 1.1-2.6) and history of falls (OR = 4.7, 95% CI, 3.5-6.3) were the strongest significant predictors of falls. In stratified multivariate analyses, preclinical disability equally predicted falls in participants with (OR = 1.7, 95% CI, 1.0-3.0) and without history of falls (OR = 1.8, 95% CI, 1.1-3.0). Conclusions. This study provides longitudinal evidence that self-reported preclinical disability predicts incident falls at 1-year follow-up independent of other self-reported fall risk factors. Multidimensional geriatric assessment that includes preclinical disability may provide a unique early warning system as well as potential targets for intervention.     <p>Language: en</p>
LA  - en
SN  - 1079-5006
UR  - http://dx.doi.org/
ID  - ref1
ER  -