Monitoring Falls in Cohort Studies of Community-Dwelling Older People: Effect of the Recall Interval

Authors

  • David A. Ganz MD, MPH,

    1. From the *Robert Wood Johnson Clinical Scholars Program, Los Angeles, CaliforniaVeterans Affairs Greater Los Angeles Health Care System, Los Angeles, CaliforniaMulticampus Program in Geriatric Medicine and Gerontology§Specialty Training and Advanced Research Program, University of California at Los Angeles, Los Angeles, CaliforniaDepartment of Epidemiology and Healthcare Research, Kyoto University, Kyoto, Japan.
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  • Takahiro Higashi MD, PhD,

    1. From the *Robert Wood Johnson Clinical Scholars Program, Los Angeles, CaliforniaVeterans Affairs Greater Los Angeles Health Care System, Los Angeles, CaliforniaMulticampus Program in Geriatric Medicine and Gerontology§Specialty Training and Advanced Research Program, University of California at Los Angeles, Los Angeles, CaliforniaDepartment of Epidemiology and Healthcare Research, Kyoto University, Kyoto, Japan.
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  • Laurence Z. Rubenstein MD, MPH

    1. From the *Robert Wood Johnson Clinical Scholars Program, Los Angeles, CaliforniaVeterans Affairs Greater Los Angeles Health Care System, Los Angeles, CaliforniaMulticampus Program in Geriatric Medicine and Gerontology§Specialty Training and Advanced Research Program, University of California at Los Angeles, Los Angeles, CaliforniaDepartment of Epidemiology and Healthcare Research, Kyoto University, Kyoto, Japan.
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  • DAG and LZR are supported by the Department of Veterans Affairs. DAG is also supported by the Robert Wood Johnson Clinical Scholars Program and LZR by the Archstone Foundation.

Address correspondence to David Ganz, MD, MPH, Robert Wood Johnson Clinical Scholars Program, 911 Broxton Plaza, 3rd Floor, Los Angeles, CA 90024. E-mail: dganz@mednet.ucla.edu

Abstract

Objectives: To determine whether the interval over which patients are asked to remember their falls affects fall reporting.

Design: Systematic literature review.

Setting: Community.

Participants: Individuals being monitored for falls in prospective studies that asked participants to recall falls over varying intervals.

Measurements: Sensitivity and specificity of retrospective recall compared with a criterion-standard prospective assessment using some form of ongoing fall monitoring.

Results: Six studies met the inclusion criteria. Recall of falls in the previous year was specific (specificity 91–95%) but less sensitive (sensitivity 80–89%) than the criterion standard of ongoing prospective collection of fall data using fall calendars or postcards. Patients with injurious falls were more likely to recall their falls. Lower Mini-Mental State Examination score was associated with poorer recall of falls in the one study addressing this issue.

Conclusion: Whenever accurate data on all falls are critical, such as with interventions to decrease the rate of falls, researchers should gather information on falls every week or every month from study participants. The optimal method of fall monitoring—postcard, calendar, diary, telephone, or some combination of these—remains unknown.

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