Ruchinskas R: Clinical prediction of falls in the elderly. Am J Phys Med Rehabil 2003;82:273–278.
Objective: To assess the ability of physical and occupational therapists engaged in rehabilitation of the elderly to predict posttreatment falls.
Design: Prospective cohort study of 15 mo in duration at an urban academic medical center rehabilitation unit. A total of 165 consecutively admitted geriatric individuals were rated for fall risk by 14 physical and seven occupational therapists. Measurements included the Mini-Mental State Examination, Geriatric Depression Scale, FIM™, and therapists’ ratings of fall likelihood.
Results: Both disciplines evidenced an ability to predict who would fall in the 3 mo after discharge. Clinical judgment regarding fall risk, however, added little value over two major predictors of future falls, fall history and the presence of a neurologic condition.
Conclusion: Trying to predict an infrequent future event such as falls is inherently difficult. Education regarding known fall-risk factors and inclusion of standardized measurements of physical status are recommended to potentially improve rates of detection, along with adoption of a realistic attitude regarding our abilities to forecast infrequent events.
From the Department of Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, Pennsylvania.
FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.
All correspondence and requests for reprints should be addressed to Robert Ruchinskas, PsyD, Department of Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, PA 19140.