The Self-rated Fall Risk Questionnaire and Modified Falls Efficacy Scale in Assessing the Fall Risk in Community-dwelling Older Chinese Adults: a Comparative Study

Abstract

Background The Self-rated Fall Risk Questionnaire (FRQ) developed by the US CDC is one of the few questionnaires applied for fall risk self-assessment in community-dwelling older adults, which is thought to be simple and highly applicable. The Modified Falls Efficacy Scale (MFES) is also widely used in the fall risk assessment in older adults. Thus the comparison between the Self-rated FRQ and MFES in identifying fall risk in older adults would be meaningful. Objective To explore the applicability of the Chinese version of Self-rated FRQ (FRQ-C) in assessing the fall risks in community-dwelling older Chinese adults by comparing it with the Chinese version of MFES (MFES-C) . Methods A total of 203 seniors above 65 who received physical examination services, treatment services, or vaccination services from the community health center were selected by use of convenience sampling and invited to attend a survey for understanding their demographics, and fall risk rated by the MFES-C and the Self-rated FRQ-C. ROC analysis was conducted to assess the performance (sensitivity, specificity, positive and negative predictive values) of the Self-rated FRQ-C and MFES-C in the prediction of having at least one or two falls in the past year. Results Fifty-eight (28.6%) of them fell once or more in the past year. The mean score of the Self-rated FRQ-C for the fall group was higher than that of the non-fall group with a statistically significant difference (P<0.001) . But no significant difference in the mean score of the MFES-C was found between the two groups (P>0.05) . Those with high fall risk assessed by the Self-rated FRQ-C (≥4 points) had higher prevalence of fall (P<0.05) . However, no higher prevalence of fall was found in those with high fall risk assessed by the MFES-C (≤112 points) (P>0.05) . The AUC values in identifying having one or more falls in the past year for the Self-rated FRQ-C and MFES-C were 0.74〔95%CI (0.68, 0.81) 〕 and 0.59〔95%CI (0.50, 0.68) 〕. When identifying having two or more falls in the past year, the AUC value of the Self-rated FRQ-C increased to 0.80〔95%CI (0.70, 0.90) 〕, and that of the MFES-C increased to 0.65〔95%CI (0.52, 0.78) 〕. The sensitivity and specificity of the Self-rated FRQ-C with a threshold of 4 points were 81.0% and 51.7%, respectively, and those of the MFES-C with a threshold of 112 points were 53.5% and 60.0%, respectively. Conclusion Compared with the MFES-C, the Self-rated FRQ-C may have higher sensitivity in identifying fall risk in older adults with higher operability and applicability in community settings.

Keywords

• self-rated fall risk questionnaire|modified fall efficacy scale|falls|risk assessment|community health services|aged