Date of Award:

12-2024

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Psychology

Committee Chair(s)

JoAnn T. Tschanz

Committee

JoAnn T. Tschanz

Committee

Chris Warren

Committee

Gail B. Rattinger

Committee

David Bolton

Committee

M. Scott DeBerard

Committee

Sarah Schwartz

Abstract

One out of four adults over the age of 65 are estimated to fall each year in the U.S. alone, with that number expected to rise to 52 million falls per year by the year 2030. Improving accuracy for identification of older adults at a higher risk of falling is increasingly important and may be integral in informing the distribution of limited resources and assist in preventing falls in older adults. This project examined the relationship between previously identified risk factors and fall risk to create multidimensional fall risk indexes for older adults, specific for each sex.

Factors best associated with risk of falling for females included having a history of past falling, sociodemographic information, dependence on instrumental activities of daily living, cognitive status, number of medical conditions, fall risk inducing drug (FRID) use, and being underweight. For males, the above domains, except for being underweight and use of FRIDs were associated with risk of falling.

These risk factors were used to create and validate a fall risk index, separately for each sex. The index for females predicted fall risk such that for every one-point increase on the index, there was a doubling in the hazard of experiencing a future fall, whereas for males, there was a 77% higher hazard of falling for every one-point increase on the index. With respect to the accuracy of the index, for females, the index correctly identified a future fall 69%, 74%, and 79% of the time at 1, 5, and 10 years into the study, respectively. For males, the index correctly identified a future fall 63%, 70%, and 75% of the time at each of the above time points.

The results of this study demonstrated improvement in predicting the risk of falls compared to several previously established and validated measures for evaluating fall risk and provide support to the hypothesis that fall risk is multifactorial. This project additionally highlights the role that sex plays in fall risk and is the first fall risk index developed for each sex.

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