The study is based on data collected in the context of the Longitudinal Aging Study Amsterdam (LASA), which is funded by the Ministry of Health, Welfare, and Sports of the Netherlands. The study on falls was supported by ZonMw, The Hague.
A Classification Tree for Predicting Recurrent Falling in Community-Dwelling Older Persons
Article first published online: 23 SEP 2003
Journal of the American Geriatrics Society
Volume 51, Issue 10, pages 1356–1364, October 2003
How to Cite
Stel, V. S., Pluijm, S. M. F., Deeg, D. J. H., Smit, J. H., Bouter, L. M. and Lips, P. (2003), A Classification Tree for Predicting Recurrent Falling in Community-Dwelling Older Persons. Journal of the American Geriatrics Society, 51: 1356–1364. doi: 10.1046/j.1532-5415.2003.51452.x
- Issue published online: 23 SEP 2003
- Article first published online: 23 SEP 2003
- accidental falls;
- risk factors;
- survival analysis
Objectives: To develop a classification tree for predicting the risk of recurrent falling in community-dwelling older persons using tree-structured survival analysis (TSSA).
Design: A prospective cohort study.
Setting: A community in the Netherlands.
Participants: One thousand three hundred sixty-five community-dwelling older persons (≥65) from the Longitudinal Aging Study Amsterdam (LASA).
Measurements: In 1995, physical, cognitive, emotional, and social aspects of functioning were assessed. Subsequently, a prospective fall follow-up, specifically on recurrent falls (two falls within 6 months) was conducted for 3 years.
Results: The classification tree included 11 end groups differing in risk of recurrent falling based on a minimum of two and a maximum of six predictors. The first split in the tree involved two or more falls versus fewer than two falls in the year preceding the interview. Respondents with two or more falls in the year preceding the interview (n=193) and with at least two functional limitations (n=98) had a 75% risk of becoming a recurrent faller, whereas respondents with fewer than two functional limitations were further divided into a group with regular dizziness (n=11, risk of 68%) and a group with no regular dizziness (n=84, risk of 30%). In respondents with fewer than two falls in the year preceding the interview (n=1,172), the risk of becoming a recurrent faller varied between 9% and 70%. Predictors in this branch of the tree were low performance, low handgrip strength, alcohol use, pain, high level of education, and high level of physical activity.
Conclusion: This classification tree included 11 end groups differing in the risk of recurrent falling based on specific combinations of a maximum of six easily measurable predictors. The classification tree can identify subjects who are eligible for preventive measures in public health strategies.