Development of a proposed scale for assessing fall risk in older adults in primary care

Abstract

Introduction

Population aging has been accompanied by an increase in falls among older adults, constituting an important public health problem, particularly in primary care; however, fall risk assessment continues to rely on instruments developed for hospital settings that are poorly sensitive to the specific features of community settings.

Objective

To develop an easy-to-use scale for assessing fall risk in older adults in primary care, based on the identification of clinical, sociodemographic, and psychosocial factors associated with previous falls.

Methods

An observational, analytical, cross-sectional, quantitative study was initially conducted with a convenience sample of 322 older adults to identify factors associated with falls. Based on these results, a methodological study was conducted, enabling the construction of a fall risk assessment scale using coefficients from a logistic regression model.

Results

Inferential analysis identified significant associations between falls and sociodemographic, clinical, and functional variables that, after multicollinearity analysis, were used to define and fit a logistic regression model. The final model included four predictors - history of falls, age, fear of falling, and living arrangement—whose coefficients were converted into point values to construct a proposed fall risk assessment scale.

Conclusion

Fall risk in older adults is multifactorial, and the lack of instruments specifically designed for primary care hinders its early identification. This study enabled the development of a fall risk assessment scale with potential for use in identifying fall risk in older adults; however, evaluation in the development sample limits the generalizability of the findings, and future external validation is needed.