Journal article
Assessing the cutoffs of four commonly used fall risk assessment tools for old Chinese community-dwellers: A prospective study
Journal of safety research, Vol.95, pp.125-132
12/2025
DOI: 10.1016/j.jsr.2025.09.011
PMID: 41338769
Abstract
•The cutoffs for four common fall risk assessment tools based on a Chinese sample differed from those developed outside China.•The new cutoffs for four tools showed improved sensitivity but reduced specificity than those developed outside China.•Both sets of cutoffs failed to achieve acceptable performance in predicting 12-month falls and fall-related injuries.
Introduction: To compare predictive performances of existing cutoffs developed outside China for four commonly-used fall risk assessment tools and new cutoffs based on a Chinese sample. Method: A 12-month prospective study was conducted between April 2023 and June 2024 in Changsha, China. The Stay Independent Brochure Questionnaire (SIB), Fall Efficacy Scale International (FES-I), Home Falls and Accidents Screening Tool (HOME FAST), and Time Up and Go Test (TUGT) were included. New cutoffs were developed by plotting receiver operating characteristic (ROC) curves and calculating the largest Youden index. Chi-square test was used to compare predictive performances of new and old cutoffs for the same assessment tools. Results: The study was completed by 1,237 older adults. The new cutoffs for SIB, FES-I, HOME FAST, and TUGT in predicting falls were 3 points, 18 points, 5 points, and 10.6s, respectively, with AUC values ranging from 0.513 (95% CI: 0.485-0.542) for HOME FAST to 0.631 (95% CI: 0.604-0.658) for SIB. For predicting fall-related injuries, the new cutoffs were 3 points for SIB, 26 points for FES-I, 5 points for HOME FAST, and 11.7s for TUGT, with AUC values ranging from 0.530 (95% CI: 0.502-0.558) for HOME FAST to 0.628 (95% CI: 0.601-0.655) for SIB. Compared with the existing cutoffs, the new cutoff values for all tools generally showed significantly improved sensitivities but reduced specificities. Conclusions: The newly-determined cutoffs showed somewhat improved predictive performance over the existing cutoffs in sensitivity, but neither set of cutoffs achieved good predictive performance among older Chinese community-dwellers when the fall risk assessment results were used solely, without supplemental information. Practical Applications: Considering the poor predictive performances of the four commonly-used fall risk assessment tools with either set of cutoffs, we recommend use of the tools along with supplemental information to predict future fall risk among older adults in China.
Details
- Title: Subtitle
- Assessing the cutoffs of four commonly used fall risk assessment tools for old Chinese community-dwellers: A prospective study
- Creators
- Weiqiang Li - Central South UniversityYanhong Fu - Central South UniversityYouyou Wu - Central South UniversityDavid C. Schwebel - University of Alabama at BirminghamGe Lei - Yuelu District Lugu Hospital, Changsha, Hunan Province, ChinaHuan Liu - Yuelu District Lugu Hospital, Changsha, Hunan Province, ChinaMin Zhao - Central South UniversityTongfei Zhang - Central South UniversityLi Li - Central South UniversityPeishan Ning - Central South UniversityZhenzhen Rao - Central South UniversityGuoqing Hu - Central South University
- Resource Type
- Journal article
- Publication Details
- Journal of safety research, Vol.95, pp.125-132
- DOI
- 10.1016/j.jsr.2025.09.011
- PMID
- 41338769
- NLM abbreviation
- J Safety Res
- ISSN
- 0022-4375
- eISSN
- 1879-1247
- Publisher
- Elsevier Ltd
- Number of pages
- 8
- Grant note
- National Key Research and Develop-ment Program of China: 2022YFC3603000
This work was supported by National Key Research and Develop-ment Program of China (No. 2022YFC3603000) .
- Language
- English
- Electronic publication date
- 09/22/2025
- Date published
- 12/2025
- Academic Unit
- Research Administration; Psychological and Brain Sciences
- Record Identifier
- 9984964810402771
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