A classification tree for predicting recurrent falling in community-dwelling older persons

Vianda S Stel, Saskia M F Pluijm, Dorly J H Deeg, Johannes H Smit, Lex M Bouter, Paul Lips

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1356-64
Number of pages9
JournalJournal of the American Geriatrics Society
Volume51
Issue number10
DOIs
Publication statusPublished - Oct 2003

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Accidental Falls
Independent Living
Dizziness
Interviews
Survival Analysis
Netherlands
Longitudinal Studies
Cohort Studies
Public Health
Alcohols
Prospective Studies
Education
Pain

Keywords

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Data Interpretation, Statistical
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Netherlands
  • Predictive Value of Tests
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Stel, Vianda S ; Pluijm, Saskia M F ; Deeg, Dorly J H ; Smit, Johannes H ; Bouter, Lex M ; Lips, Paul. / A classification tree for predicting recurrent falling in community-dwelling older persons. In: Journal of the American Geriatrics Society. 2003 ; Vol. 51, No. 10. pp. 1356-64.
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A classification tree for predicting recurrent falling in community-dwelling older persons. / Stel, Vianda S; Pluijm, Saskia M F; Deeg, Dorly J H; Smit, Johannes H; Bouter, Lex M; Lips, Paul.

In: Journal of the American Geriatrics Society, Vol. 51, No. 10, 10.2003, p. 1356-64.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - A classification tree for predicting recurrent falling in community-dwelling older persons

AU - Stel, Vianda S

AU - Pluijm, Saskia M F

AU - Deeg, Dorly J H

AU - Smit, Johannes H

AU - Bouter, Lex M

AU - Lips, Paul

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N2 - 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.

AB - 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.

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KW - Aged

KW - Aged, 80 and over

KW - Data Interpretation, Statistical

KW - Female

KW - Geriatric Assessment

KW - Humans

KW - Male

KW - Netherlands

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Recurrence

KW - Risk Assessment

KW - Risk Factors

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1046/j.1532-5415.2003.51452.x

DO - 10.1046/j.1532-5415.2003.51452.x

M3 - Article

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SP - 1356

EP - 1364

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 10

ER -