Predictive validity and cut-off scores in four diagnostic tests for falls – a study in frail older people at home

Abstract

No study has investigated the predictive validity and cut-off scores in diagnostic tests for falls used in in-home assessment in frail older people. The objective was to investigate the predictive validity for falls in the Downton Fall Risk Index (DFRI), Timed Up and Go (TUG) and Romberg test (RT) used in in-home assessment of frail older people (65+ years). Data on the diagnostic tests were collected at baseline (N = 153) and fall frequency were collected at six- and twelve-month follow-ups. The optimal cut-offs were 3 p in DFRI and 12 s in TUG. However, the validity indexes were generally low and only 40–50% were correctly classified. The RT showed low sensitivity. To increase the predictive validity for falls in this context, the use of DFRI and/or TUG as a part of a comprehensive fall-risk assessment tool, should be investigated in future studies.