The Mobility Interaction Fall chart.

Abstract

BACKGROUND AND PURPOSE: The aim of this study was to develop and evaluate a screening tool for the identification of older people living in residential care facilities who are prone to falling. METHOD: Two tests focusing on attentional demands while walking were performed: 'Stops walking when talking' and the 'diffTUG'. Medical assessment, rating for cognition, depression and activities of daily living were also carried out. Falls indoors were followed up prospectively over a period of six months. A flowchart, the Mobility Interaction Fall (MIF) chart, for the identification of older people who are prone to falling was developed. The MIF chart includes an observation of mobility level and 'Stops walking when talking', the diffTUG, a test of vision and a rating of concentration. Study subjects were 78 residents, aged over 65 years, in one residential care facility (22 M; 56 F; median age 82 years, range 66-99 years) in Umeå, Sweden. RESULTS: Thirty-three (42%) subjects suffered at least one fall indoors during the follow-up period. The rate of falls differed significantly between those subjects classified as being at risk of falls and those not so classified (log rank test 39.1; p < 0.001; hazard ratio 12.1; 95% CI 4.6-31.8). The positive predictive value for the classification was 78% (95% CI 67-87%) and the negative predictive value was 88% (95% CI 79-95%). CONCLUSION: The initial findings for the MIF chart indicate a promising way of classifying older people at residential care facilities as being at high or low risk of falling. The classification is quick and easy and requires no expensive equipment.