Fall risk screening in older adults using the “CARE” frailty scale: The NuAge cohort results

Background

“CARE” is an electronic health (e-health) application (app) which assesses frailty with its frailty module and risk of falls with its mobility module. This study examines and compares the risk of incident falls (i.e., ≥1, ≥2 and severe falls) among older people in Quebec classified as “frail” and those classified as being at a high risk of falls by the CARE app.

Methods

A subset of men and women (n = 1151; 74.2 ± 4.2 years; 52.8 % female) who participated in the Quebec Longitudinal Study on Nutrition and Successful Aging (NuAge) were selected for this study. Pre-frail and frail states using the CARE frailty scale as well as high risk of falls estimated by CARE mobility module were determined at baseline. Pre-frail and frail states were merged in a single “frail state” group. Incident falls (i.e., ≥1, ≥2 and severe falls) were annually recorded over a 3-year follow-up.

Results

Both CARE frail state (Odd ratio (OR) ≥1.89 with P ≥ 0.040) and high risk of falls estimated by the CARE mobility module (OR) ≥3.32 with P ≥ 0.023) were significantly associated with incident falls (i.e., at least one fall) and recurrent falls (i.e., at least two falls). A greater association with these fall outcomes was observed with the high risk of falls than with the frail state. No significant association between the high risk of falls and severe falls was found (OR = 1.71 with P = 0.227), whereas that was the case with frail state (OR = 3.08 with P = 0.003).

Conclusions

Frail state determined by the CARE frailty module and high risk of falls determined by the CARE mobility module were both significantly associated with fall outcomes, a greater association being shown with the CARE high risk of falls and with CARE frail state for severe falls. These results suggest that the CARE app may be useful for screening older people for the risk of falls.