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

N. Kluft, S. M. Bruijn, R. H.A. Weijer, J. H. Van Dieën, M. Pijnappels*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


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 Factor10 ≤ 0.5).

Original languageEnglish
Article number190786
JournalRoyal Society Open Science
Issue number11
Publication statusPublished - 1 Nov 2019


  • Age
  • Balance control
  • Falls
  • Locomotion
  • Strategy selection


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