Validation of the German falls risk questionnaire, fall risk check (FRC), in community-dwelling seniors : A diagnostic accuracy study.

Background: Falls are a significant health problem for seniors, often indicating increasing mobility impairment and risk of injury. Although necessary for the identification of seniors at risk, only few validated German questionnaires on falls risk exist.

Objective: To validate the German Fall Risk Check (FRC) in independently living, community-dwelling older people against objective measurement of standing and walking balance as assessed by the Short Physical Performance Battery (SPPB).

Material and methods: In a larger randomized controlled trial, evaluating home emergency call systems, we recruited 190 seniors in Hamburg, Germany, to fill in the FRC and pass a comprehensive geriatric assessment. The performance of FRC as a diagnostic test is described by typical measures, such as sensitivity (SN), specificity (SP), predictive values, positive/negative likelihood ratios (LR+/LR-), and area under the curve (AUC) in receiver operator characteristic (ROC) curve analysis, each with corresponding 95% confidence intervals (CI).

Results: In total, 190 seniors with an average age 80.5 years (± 5.5 years), 75.3% women could be analyzed. The sample showed advanced comorbidity and concerns about falling in about one third, and mobility and cognitive impairment in about one half. We calculated: SN 0.679 (95% CI 0.571-0.771); SP 0.743 (95% CI 0.654-0.816); LR+ 2.643 (95% CI 1.858-3.761); and LR- 0.432 (95% CI 0.309-0.604). The unadjusted AUC was 0.711 (95% CI 0.635-0.787), adjusted for sex and age 0.753 (95% CI 0.683-0.824).

Conclusion: The FRC appears to be a valid questionnaire, identifying impaired balance in community-dwelling seniors.