Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA.
College of Nursing, University of Central Florida, Orlando, FL, USA.
Clin Interv Aging. 2024 Mar 27;19:581-588. doi: 10.2147/CIA.S453966. eCollection 2024.
The US Centers for Disease Control and Prevention (CDC) has implemented the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. This initiative provides an algorithm for fall risk screening. However, the algorithm has the potential to overcategorize individuals as high risk for falling upon initial screening, which may burden clinicians with the task of recategorizing individuals after follow-up testing. Therefore, this study aimed to compare the accuracy, sensitivity, and specificity of fall risk appraisal between the STEADI, Short Fall-Efficacy Scale International (FES-I), and portable balance system (BTrackS) assessments in community-dwelling older adults.
This cross-sectional analysis included 122 community-dwelling older adults, comprising 94 women and 28 men. Center-of-pressure postural sway was assessed using the BTrackS, fear of falling was assessed using the Short FES-I questionnaire, and all participants completed the STEADI checklist. Each assessment categorized participants as either high or low fall risk and fall risk appraisal was compared between groups using McNemar tests.
The STEADI checklist (high risk: n = 62; low risk: n = 60) significantly differed in fall risk appraisal compared to the BTrackS (high risk: n = 44; low risk: n = 78; p = 0.014) and the Short FES-I (high risk: n = 42; low risk: n = 80; p = 0.002). Compared to the BTrackS, the STEADI checklist had a specificity of 62.8%, sensitivity of 70.5%, and accuracy of 65.6%. Compared to the Short FES-I, the STEADI checklist had a specificity of 67.5%, sensitivity of 81.0%, and accuracy of 72.1%.
The STEADI checklist appears to overcategorize individuals as high fall risk more frequently than direct assessments of postural sway and fear of falling. Further research is needed to examine potential improvements in accuracy when combining the STEADI checklist with direct assessments of postural sway and/or fear of falling.
美国疾病控制与预防中心（CDC）已经实施了“阻止老年人意外伤害、死亡和伤害（STEADI）”计划。该计划提供了一种跌倒风险筛查算法。然而，该算法有可能在初次筛查时将个体过度归类为高跌倒风险，这可能会给临床医生带来后续测试后重新归类个体的任务。因此，本研究旨在比较 STEADI、短跌倒效能量表国际版（FES-I）和便携式平衡系统（BTrackS）评估在社区居住的老年人中跌倒风险评估的准确性、敏感性和特异性。
这项横断面分析纳入了 122 名社区居住的老年人，包括 94 名女性和 28 名男性。使用 BTrackS 评估中心压力姿势摆动，使用短 FES-I 问卷评估跌倒恐惧，所有参与者完成 STEADI 清单。每个评估将参与者归类为高或低跌倒风险，并使用 McNemar 检验比较组间的跌倒风险评估。
STEADI 清单（高风险：n=62；低风险：n=60）与 BTrackS（高风险：n=44；低风险：n=78；p=0.014）和短 FES-I（高风险：n=42；低风险：n=80；p=0.002）在跌倒风险评估方面存在显著差异。与 BTrackS 相比，STEADI 清单的特异性为 62.8%，敏感性为 70.5%，准确性为 65.6%。与短 FES-I 相比，STEADI 清单的特异性为 67.5%，敏感性为 81.0%，准确性为 72.1%。
STEADI 清单似乎比直接评估姿势摆动和跌倒恐惧更频繁地将个体过度归类为高跌倒风险。需要进一步研究，以检查当 STEADI 清单与直接评估姿势摆动和/或跌倒恐惧相结合时，准确性是否有所提高。
