Open AccessStepping-forward affordance perception test cut-offs: Red-flags to identify community-dwelling older adults at high risk of falling and of recurrent falling
Author(s) -
Catarina Pereira,
Jorge Bravo,
Guida Veiga,
José Marmeleira,
Felismina Rosa Parreira Mendes,
Gabriela Almeida
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0239837
Subject(s) - receiver operating characteristic , percentile , falling (accident) , logistic regression , medicine , physical medicine and rehabilitation , falls in older adults , poison control , injury prevention , risk assessment , physical therapy , psychology , statistics , computer science , medical emergency , mathematics , computer security , environmental health
The stepping-forward affordance perception test (SF-APT) fills an important gap within the screening of falls risk factors by considering the perception of affordances . The test showed to be a valid instrument for community-dwelling older adults falls risk assessment. The present study aimed to distinguish and test the key outcomes of the SF-APT usable for falls risk assessment in community-dwelling older adults to determine the respective cut-offs. This cross-sectional study enrolled 347 participants (73.1 ± 6.2 years; non-fallers: 57.9%; fallers: 42.1%; recurrent-fallers: 17.9%). Falls occurrence and SF-APT outcomes were assessed. Analyses were performed using multivariate binary logistic regression analysis and receiver operating characteristic (ROC). The area under the ROC curve was computed (AUC) for each built model explaining falling or recurrent falling. Results distinguished the Estimated stepping-forward, and Absolute-error in interaction with Error-tendency as the SF-APT key outcomes for falls risk assessment [AUC falling : 0.665 (CI 95%: 0.608–0.723); AUC falling recurrently : 0.728 (CI 95%: 0.655–0.797)]. Computed cut-offs’ analysis showed that (i) a boundary stepping-forward estimation >58 cm plus an underestimation bias >5 cm (>42 nd percentile) avoid older adults to be recurrent-fallers, and (ii) a boundary stepping-forward estimation >62 cm plus an underestimation bias >6 cm (>54 th percentile) avoid older adults to be fallers. In conclusion, results suggest that SF-APT is a valuable tool for falls risk assessment in community-dwelling older adults. Interventions targeting the prevention of falls should consider the above key outcomes and the respective cut-offs as alert red-flags.