Stepping-forward affordance perception test cut-offs: Red-flags to identify community-dwelling older adults at high risk of falling and of recurrent falling

Pereira, Catarina; Bravo, Jorge; Veiga, Guida; Marmeleira, José; Mendes, Felismina Rosa Parreira; Almeida, Gabriela

doi:10.1371/journal.pone.0239837

Cited by 6 publications

(6 citation statements)

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“…With respect to the perceived action boundary, the performance-related and exposure risk factor, the present study results con rmed previous ndings [17], showing that the stepping-forward action perceived overestimation is a serious risk for falling.…”

Section: Discussionsupporting

confidence: 90%

“…Literature usually points the main risk factors for falling as advancing age, female gender, history of previous falls, chronic health conditions (e.g., cardiovascular diseases, disorders of the nervous system, poor vision, or foot impairment), cognitive de cits, poor body composition, low lower limb strength, impaired balance and gait, impaired dual-task performance, environmental hazards and lifestyle habits such as physical (in)activity [7,[12][13][14][15][16]. In addition, a recent study found that the bias of overestimation of the perceived maximum performance for the stepping-forward task is also an important risk factor for falling [17].…”

Section: Introductionmentioning

confidence: 99%

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Dynamic Performance-exposure Algorithm for Falling Risk Assessment and Fall Prevention in Community-dwelling Older Adults

Pereira

Rosado

Almeida

et al. 2021

Preprint

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Background: Several models and algorithms were designed to identify older adults at risk of falling supported on an intrinsically and extrinsically traditional approach. However, the dynamic interaction between multiple risk factors for falls must be considered. The present study aimed to design a dynamic performance-exposure algorithm for falling risk assessment and fall prevention in community-dwelling older adults.Methods: The study involved 1) a cross-sectional survey assessing retrospective falls, performance-related risk factors for falls (sociodemographic such as gender and age, cognitive, health conditions, body composition, physical fitness, and dual-task outcomes), exposure risk factors (environmental hazards and (in)physical activity), and performance-exposure risk factors (affordance perception), and 2) follow-up survey assessing prospective falls. Participants were Portuguese community dwellings (≥ 65 years). Data were reported based upon descriptive statistics, curve estimation regression, binary logistic regression, and ROC curve.Results: The selected and ordered outcomes included in the algorithm and respective cutoffs were: (1) falls in previous year (high risk: n>1, moderated: n=1, low risk: n=0); (2) health conditions (high risk: n >3, moderated: n=3, low risk: n<3); (3) multidimensional balance (high risk: score <32 points, moderated risk: 32 points ≤ score ≤33 points, low risk: score>33); (4) lower body strength (high risk: rep/30s< 11, moderated risk: 11≤ rep/30s ≤14, low risk: rep/30s >4); (5) perceiving action boundaries (high risk: overestimation bias, moderated risk: not applied, low risk: underestimation bias); (6) fat body mass (high risk: % fat >38, moderated risk: 37≤ % fat ≤38, low risk: % fat <7); (7) environmental hazards (high risk: n>5, moderated risk: n=5, low risk: n<5); (8) rest period (high risk: hours/day >4.5, moderated risk: 4≤ hours/day ≤4.5, low risk: hours/day <4); (9) physical activity metabolic expenditure (high risk: MET-min/week <2300 or >5200, moderated risk: 2300≤ MET-min/week <2800, low risk: 2800≤ MET-min/week ≤5200).Conclusions: Results demonstrated a dynamic relationship between older adults’ performance capacity and the exposure to falls opportunity, supporting the build algorithm’s conceptual framework. Fall prevention measures should consider the above factors that most contribute to the individual risk of falling, relative weights, and their distance from low-risk value, as proposed in the dynamic algorithm.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Dynamic Performance-exposure Algorithm for Falling Risk Assessment and Fall Prevention in Community-dwelling Older Adults

Pereira

Rosado

Almeida

et al. 2021

Preprint

Self Cite

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“…Our results indicate that FoF is associated with a higher risk of falling in communitydwelling frail and pre-frail older people. A score of 20 points or more on the FES-I scale is indicative of a three-fold risk of falling in this population, signaling the need for specific prevention strategies [49].…”

Section: Discussionmentioning

confidence: 99%

Fear of Falling Score Is a Predictor of Falls in Community-Dwelling Pre-Frail and Frail Older People

et al. 2023

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Identifying frail older people at risk of falling is a priority in order to apply preventive strategies. This cross-sectional study included community-dwelling pre-frail and frail people (Fried’s criteria) aged 70 years and older to assess the prevalence of falls and identify screening strategies based on comprehensive geriatric assessments to detect an increased risk of falling and recurrent falling in community-dwelling frail and pre-frail old people. Of the 229 participants, 121 (54.9%) had fallen in the previous 12 months, and 20 of these (16.5%) were recurrent fallers (≥2 falls). A score of 20 points or more on the Falls Efficacy Scale International was predictive of falling (area under the receiver-operating characteristics curve 0.67, 95% confidence interval: 0.61–0.74, p < 0.001) with a sensitivity of 51.7% and a specificity of 73.9%. Polypharmacy, Short Physical Performance Battery score of 8 points or less, and Falls Efficacy Scale International score of 20 points or more show an area under the curve of 0.78 (95% confidence interval: 0.67–0.89, p < 0.001) for recurrent falling.

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“…O SF-APT é um instrumento válido para avaliação de risco de quedas de idosos residentes na comunidade. (Pereira et al, 2020).…”

Section: Stepping-forward Affordance Perception Test (Sf-apt)unclassified

Instrumentos que avaliam risco de quedas em idosos: uma revisão integrativa

Monteiro,

Castro,

Nascimento

et al. 2023

RSD

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O objetivo é analisar os instrumentos mais utilizados na literatura e descrever o grau de sensibilidade e especificidade dos mesmos, para avaliar risco de quedas em pessoas idosas. Metodologia: É uma revisão integrativa, de caráter qualitativo. As buscas ocorreram entre os meses de maio a outubro, nas bases de dados PubMed, Science Direct,LiLacs, Scielo, BVS e PeDro, de acordo com a questão da pesquisa, delimitada pela estratégia PICO. As estratégias de buscas foram formadas por meio de termos indexados ao DECs/Mesh e no processo de filtragem foram considerados elegíveis estudos que avaliam o risco de quedas em idosos e que apresentam a sensibilidade e especificidade de cada instrumento, dentro dos critérios de inclusão estabelecidos pelos autores, nos idiomas português, inglês e espanhol. Não houve restrição quanto ao ano de publicação. Resultados: Foram selecionados 4.109 artigos. Após o processo de filtragem por títulos, resumos e leitura completa, nove artigos foram elegíveis e incluídos na revisão. A amostra total compreende 1.715 pessoas idosas, com idade média de 72,5 anos. Os instrumentos: BESTest, Mini - BESTest, SF- APT, MCHSAT, Quicksreen, 30s-CST e 30s CST modificado apresentaram melhores resultados para sensibilidade e especificidade, quando comparados aos outros instrumentos estudados. Conclusão: O presente estudo apresentou os instrumentos mais utilizados na literatura para avaliação do risco de quedas em idosos, assim como, os descreveu e expôs o grau de sensibilidade especificidade de cada.

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Stepping-forward affordance perception test cut-offs: Red-flags to identify community-dwelling older adults at high risk of falling and of recurrent falling

Cited by 6 publications

References 33 publications

Dynamic Performance-exposure Algorithm for Falling Risk Assessment and Fall Prevention in Community-dwelling Older Adults

Dynamic Performance-exposure Algorithm for Falling Risk Assessment and Fall Prevention in Community-dwelling Older Adults

Fear of Falling Score Is a Predictor of Falls in Community-Dwelling Pre-Frail and Frail Older People

Instrumentos que avaliam risco de quedas em idosos: uma revisão integrativa

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