Evaluating Validity Of The Fall Risk Assessment System In Comparison With Real Fall Incidents

The Fall Risk Assessment (FRA) system, incorporating tools such as a balance measure, body composition analyzer, and leg muscle dynamometer, provides a comprehensive analysis of fall risk factors to anticipate an individual's susceptibility to falling. In our previous study, evidence of convergent validity of the FRA system has been documented by comparing it with various fall risk indicators such as sarcopenia. However, identifying a relationship with real fall experiences is required to strengthen the validity of the FRA system. PURPOSE: The purpose of this study was to establish additional validity evidence for the FRA system through an association with real fall experiences. METHODS: Two hundred older adults (72.76 ± 5.61 years; 74% women) participated in this study. Participants' risk of falls was assessed through the FRA system. The composite FRA (cFRA) score was calculated by assigning weights of 10% to the sensory system score, 20% to the nervous system score, 40% to the musculoskeletal system score, and 30% to the integrated balance ability score. The lower the score, the higher the risk of falling. A questionnaire was used to investigate fall experiences. Participants were classified into one of two groups based on fall experiences (faller and non-faller). To validate the FRA system, the known-group difference method was used by comparing the cFRA score and each component score (e.g., sensory, balance, nervous, and musculoskeletal) of the FRA system between the two groups (faller vs. non-faller) using independent t-tests. RESULTS: The Levene test statistic was not significant (p > .05), indicating that the assumption of equal variances was not violated. The cFRA score of the fallers (Mean = 53.6, SD = 14.4, n = 24) was significantly lower than the non-fallers (Mean = 59.7, SD = 12.3, n = 176; p = .027). Also, the fallers (Mean = 49.0, SD = 19.1, n = 24) have lower integrated balance scores than the non-fallers (Mean = 57.4, SD = 12.8, n = 176; p = .005). CONCLUSION: The FRA system showed positive evidence in distinguishing between individuals who have experienced falls and those who have not, indicating additional validity of the FRA system established. Therefore, the FRA system appears to be a promising tool for assessing fall risk in older adults.