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. 2017 Dec;71(12):1191-1197.
doi: 10.1136/jech-2017-209769. Epub 2017 Sep 25.

Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample

Matthew C Lohman  1   2 , Rebecca S Crow  2   3   4 , Peter R DiMilia  2   4 , Emily J Nicklett  5 , Martha L Bruce  1   2 , John A Batsis  1   2   3   4
Affiliations

Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample

Matthew C Lohman et al. J Epidemiol Community Health. 2017 Dec.

Abstract

Background: Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool's predictive validity or adaptability to survey data.

Methods: Data from five annual rounds (2011-2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 years and older in the USA. Analytic sample respondents (n=7392) were categorised at baseline as having low, moderate or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level.

Results: Participants classified as having moderate and high fall risk had 2.62 (95% CI 2.29 to 2.99) and 4.76 (95% CI 3.51 to 6.47) times greater odds of falling during follow-up compared with those with low risk, respectively, controlling for sociodemographic and health-related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality.

Conclusion: The adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardise screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted.

Keywords: falls; geriatrics; injuries; measurement; screening.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Adapted STEADI algorithm for determining fall risk level.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curves comparing model prediction of any fall over the follow-up period. AUC = area under the curve
See this image and copyright information in PMC

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