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Predicting Which Older Adults Will or Will Not Fall Using the Fullerton Advanced Balance Scale

Published:November 03, 2008DOI:https://doi.org/10.1016/j.apmr.2008.05.020

      Abstract

      Hernandez D, Rose DJ. Predicting which older adults will or will not fall using the Fullerton Advanced Balance Scale.

      Objective

      The purpose of this study was to determine if the Fullerton Advanced Balance (FAB) scale can predict faller status in a group of independently functioning older adults.

      Design

      A cross-sectional design was used to establish the sensitivity and specificity of the FAB scale to predict faller status based on a retrospective self-reported fall history. For the purpose of this study, a faller was classified as an older adult with a history of 2 or more falls in the previous 12 months.

      Setting

      Multipurpose senior centers in an urban community.

      Participants

      A sample of independently functioning older adults (N=192; mean age ± SD, 77±6.5y).

      Interventions

      Not applicable.

      Main Outcome Measures

      FAB scale, a retrospective history of falls.

      Results

      Binary logistic regression analysis indicated that the total FAB scale score could be used to predict faller status (as determined by a retrospective self-reported fall history). In the present sample, the probability of falling increased by 8% with each 1-point decrease in total FAB scale score. Receiver operating characteristic analysis determined that a cut-off score of 25 out of 40 on the FAB scale produced the highest sensitivity (74.6%) and specificity (52.6%) in predicting faller status. Five individual test items on the FAB scale were particularly predictive of faller status and could be combined to form a short version of the scale that may be even more predictive of faller status and require less time to administer.

      Conclusions

      The FAB scale is a predictive measure of faller status when used with independently functioning older adults. A practitioner can be confident in more than 7 out of 10 cases that an older adult who scores 25 or lower on the FAB scale is at high risk for falls and in need of immediate intervention.

      Key Words

      List of Abbreviations:

      ADLs (activities of daily living), BBS (Berg Balance Scale), DFA (discriminant function analysis), FAB (Fullerton Advanced Balance), HAQ (Health Activity Questionnaire), OR (odds ratio), ROC (receiver operating characteristic)
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      Linked Article

      • Establishing Predictive Validity of the Fullerton Advanced Balance Scale
        Archives of Physical Medicine and RehabilitationVol. 91Issue 7
        • Preview
          The article by Hernandez and Rose1 in the December 2008 issue evaluated the Fullerton Advanced Balance (FAB) scale score in predicting of fall status in community-dwelling older adults. This is important because balance impairment is a known risk factor for falls, and clinical practice guidelines emphasize the importance of its assessment.
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