Published in

The Royal Society, Royal Society Open Science, 11(6), p. 190786, 2019

DOI: 10.1098/rsos.190786

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Does misjudgement in a stepping down paradigm predict falls in an older population?

Journal article published in 2019 by N. Kluft ORCID, S. M. Bruijn, R. H. A. Weijer, J. H. van Dieën, M. Pijnappels ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Although measures of actual and perceived physical ability appear to predict falls in older adults, a disparity between these two, also known as misjudgement, may even better explain why some older adults fall, while their peers with similar abilities do not. Therefore, we investigated whether adding a misjudgement term improved prediction of future falls. Besides conventional measures of actual (physical measures) and perceived abilities (questionnaires), we used a stepping down paradigm to quantify behavioural misjudgement. In a sample of 55 older adults (mean age 74.5 (s.d. = 6.6) years, 33 females and 20 fallers over a 10-month follow-up period), we tested the added value of a misjudgement term and of a stepping-down task by comparing experimental Bayesian logistic-regression models to a default null model, which was composed of the conventional measures: Falls Efficacy Scale international and QuickScreen. Our results showed that the default null model fitted the data most accurately; however, the accuracy of all models was low (area under the receiver operating characteristic curve (ROC) ≤ 0.65). This indicates that neither a misjudgement term based on conventional measures, nor on behavioural measures improved the prediction of future falls in older adults (Bayes Factor 10 ≤ 0.5).