Predicting falls risk in a non-English speaking older population

Abstract

Background To determine if the QuickScreen© clinical falls risk assessment tool, can accurately predict the risk of falling in non-English speaking, community-dwelling older people. To date, the QuickScreen© has not been validated for use with this population. Method A letter/matching board was designed for use with the QuickScreen’s© low contrast acuity chart, to assist the non-English speaking participants in providing a vision response. A pilot study was conducted (n=30) to assess the validity and feasibility of this board, to be used to obtain accurate acuity regardless of language skill. The QuickScreen© tool was conducted with a sample of 34 non-English speaking participants (mean age 77 years ± 6.61) and their falls were monitored for a 12 month period. Finally, these participants were investigated more thoroughly in individual case studies and their activity determined during the study period. Results The designed letter/matching board did not impact on performance by adding complexity, or enabling guessing (one-way ANOVA P = 0.66). This board was found to be easy to use and not time exhaustive. The correlation between the number of falls and the QuickScreen© falls risk score was not statistically significant (spearman correlation rs = 0.062, P = 0.73). The qualitative study provided additional information about two of the participants, suggesting the possibility of culture influencing falls risk and the need to re-consider high contrast visual acuity as a predictor of falls in older people. Conclusion The researcher successfully adapted the QuickScreen© for use in a non-English speaking population in a clinical setting. The evidence suggests that the QuickScreen© is not suitable for use with non-English speaking older people and needs revisiting in a larger community based sample; that the relative importance of falls risk factors may vary between cultural groups, suggesting that falls risk screening tools may need to be tailored to particular cultural groups.