Predictive Validity of Three Fall Risk Assessment Tools in Nursing Home Residents in Turkey: A Comparison of the Psychometric Properties.

Background: In the elderly, the functional losses associated with aging and inadequacies caused by chronic diseases can cause accidents. Falls is one of the most important problems that threaten elderly individuals and necessary precautions can be taken by evaluating the risk of falling. Fall rates in nursing homes are often substantially higher than are those in community or hospital settings. Although fall risk assessment is essential to prevent falls, there is not valid and reliable tool that can be suggested to nursing home residents. Aim: This paper is a report of a study comparing the psychometric properties of the Fall Risk Assessment (FRA), Morse Fall Scale (MFS) and Hendrich Fall Risk Model-II (HFRM-II) in nursing home residents. Methods: Data from 159 nursing home residents were assessed using three tools to detect falls: the FRA, the MFS and the HFRM-II. Results: The FRA at the cut-off level ≥12 and the HFRM-II at the cut-off level of>5 had strong sensitivity values of 88.24% and 80.39%, respectively. However, only the MFS had a more acceptable level of specificity (71.30%). Of the scales used in this study, the one with the highest AUC value according to the cut-off points we set for the scales was FRA (0.76 for FRA, 0.72 for MFS and 0.62 for HFRM-II). Conclusions: When the area under the receiver operating characteristic curve (AUC) and the four validity criteria are taken into account, the FRA showed the most satisfactory results. It was also concluded that MFS could be used in nursing homes, but that FRA was more suitable for this population because of its high sensitivity and AUC values. The discriminatory power of HFRM-II was low. Therefore, it is thought that HFRM-II should not be used for determining the risks of falls in nursing home residents. [ABSTRACT FROM AUTHOR]