Department of Nursing, Soonchunhyang University, 22 Soonchunhyang-ro, Sinchang-myen, Asan-si, Chungcheongnam-do, 31538, South Korea.
Aging Clin Exp Res. 2018 Jan;30(1):1-16. doi: 10.1007/s40520-017-0749-0. Epub 2017 Apr 3.
The prevention of falls among the elderly is arguably one of the most important public health issues in today's aging society. The aim of this study was to assess which tools best predict the risk of falls in the elderly. Electronic searches were performed using Medline, EMBASE, the Cochrane Library, CINAHL, etc., using the following keywords: "fall risk assessment", "elderly fall screening", and "elderly mobility scale". The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Selected studies were meta-analyzed with MetaDisc 1.4. A total of 33 studies were eligible out of the 2,321 studies retrieved from selected databases. Twenty-six assessment tools for fall risk were used in the selected articles, and they tended to vary based on the setting. The fall risk assessment tools currently used for the elderly did not show sufficiently high predictive validity for differentiating high and low fall risks. The Berg Balance scale and Mobility Interaction Fall chart showed stable and high specificity, while the Downton Fall Risk Index, Hendrich II Fall Risk Model, St. Thomas's Risk Assessment Tool in Falling elderly inpatients, Timed Up and Go test, and Tinetti Balance scale showed the opposite results. We concluded that rather than a single measure, two assessment tools used together would better evaluate the characteristics of falls by the elderly that can occur due to a multitude of factors and maximize the advantages of each for predicting the occurrence of falls.
预防老年人跌倒可说是当今老龄化社会中最重要的公共卫生问题之一。本研究旨在评估哪些工具最能预测老年人跌倒的风险。使用 Medline、EMBASE、Cochrane 图书馆、CINAHL 等电子数据库，使用以下关键词进行电子检索：“跌倒风险评估”、“老年人跌倒筛查”和“老年人活动能力量表”。采用 QUADAS-2 评估诊断研究的内部有效性。使用 MetaDisc 1.4 对选定的研究进行荟萃分析。从选定数据库中检索到的 2321 项研究中，有 33 项符合纳入标准。选定文章中使用了 26 种跌倒风险评估工具，这些工具往往因设置而异。目前用于老年人的跌倒风险评估工具在区分高风险和低风险跌倒方面并未显示出足够高的预测准确性。Berg 平衡量表和活动交互跌倒图表显示出稳定和较高的特异性，而 Downton 跌倒风险指数、Hendrich II 跌倒风险模型、住院老年患者跌倒圣托马斯风险评估工具、计时起立行走测试和 Tinetti 平衡量表则显示出相反的结果。我们得出结论，与其使用单一措施，不如同时使用两种评估工具，通过老年人可能因多种因素而发生的跌倒特征进行更全面的评估，并充分利用每种工具的优势来预测跌倒的发生。
