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Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults

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  • Gabriela Almeida
  • Jorge Bravo
  • Hugo Folgado
  • Hugo Rosado
  • Felismina Mendes
  • Catarina Pereira

Abstract

Thus far, few studies have examined the estimation and actual performance of locomotor ability in older adults. To our knowledge, there are no studies examining the relationship between stepping-forward estimation versus ability and fall occurrence. The aim of this study was to develop and assess the reliability and validity of a new test for fall risk assessment in community-dwelling older adults. In total, 347 participants (73.1 ± 6.2 years; 266 women) were assessed for their perception of maximum distance for the stepping-forward and action boundary. The test was developed following the existing literature and expert opinions. The task showed strong internal consistency. Intraclass correlation ranged from 0.99 to 1 for intrarater agreement and from 0.83 to 0.97 for interrater agreement. Multivariate binary regression analysis models revealed an area under the curve (AUC) of 0.665 (95% CI: 0.608–0.723) for fallers and 0.728 (95% CI: 0.655–0.797) for recurrent fallers. The stepping-forward affordance perception test (SF-APT) was demonstrated to be accurate, reliable and valid for fall risk assessment. The results showed that a large estimated stepping-forward associated with an underestimated absolute error works as a protective mechanism for fallers and recurrent fallers in community-dwelling older adults. SF-APT is safe, quick, easy to administer, well accepted and reproducible for application in community or clinical settings by either clinical or nonclinical care professionals.

Suggested Citation

  • Gabriela Almeida & Jorge Bravo & Hugo Folgado & Hugo Rosado & Felismina Mendes & Catarina Pereira, 2019. "Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-13, November.
    • Handle: RePEc:plo:pone00:0225118
    DOI: 10.1371/journal.pone.0225118
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    References listed on IDEAS

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    1. Nick Kluft & Sjoerd M Bruijn & Roel H A Weijer & Jaap H van Dieën & Mirjam Pijnappels, 2017. "On the validity and consistency of misjudgment of stepping ability in young and older adults," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-13, December.
    2. Pierpaolo Palumbo & Luca Palmerini & Stefania Bandinelli & Lorenzo Chiari, 2015. "Fall Risk Assessment Tools for Elderly Living in the Community: Can We Do Better?," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-13, December.
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