Abstract
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 language | English |
|---|---|
| Article number | 190786 |
| Journal | Royal Society Open Science |
| Volume | 6 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 1 Nov 2019 |
Funding
Ethics. All participants signed informed consent, and all procedures were approved by the local ethics committee (# VCWE 2016-147). Data accessibility. The datasets analysed for this study and all figures can be found in an Open Science Framework repository (https://osf.io/5erjw/). Authors’ contributions. All authors contributed to the conception and design of the study. N.K. built the set-up, and N.K. and R.H.A.W. collected the experimental data. N.K. developed the code for the data analysis. N.K. took the lead in writing the manuscript and designed the figures. All authors provided critical feedback and helped shaping the research, analysis and manuscript. M.P. supervised the project. All authors contributed to manuscript revision, read and approved the submitted version. Competing interests. No conflicts of interest are declared by the authors. Funding. This work was supported by a VIDIgrant (grant no. 91714344) from the Dutch Organization for Scientific Research (NWO). S.M.B. was funded by a VIDI grant (grant no. 016.Vidi.178.014) from the Dutch Organization for Scientific Research (NWO). Acknowledgements. The authors thank Jorrit Cornelissen, Lauren van Etten, Richella Hens, Lian van Rijn, Daphne Suiker, Mark Melman and Martine Rog for their assistance during data collection. We wish to express our gratitude to Leon Schutte and Siro Otten for the development of the experimental set-up.
Keywords
- Age
- Balance control
- Falls
- Locomotion
- Strategy selection