Development and preliminary examination of the predictive validity of the Falls Risk Assessment Tool (FRAT) for use in primary care

There is no validated assessment of an older person’s risk of falling that is easily applied in primary care. We aimed to develop a two-part tool for use in primary care or the community. Part 1 includes a rapid assessment of the individual’s risk of falling for administration by clinical or non-clinical staff. Part 2 (for clinical staff) includes guidance on further assessment, referral and interventions. We assessed the predictive validity of part 1. Five items were included in part 1: history of any fall in the previous year, four or more prescribed medications, diagnosis of stroke or Parkinson’s disease, reported problems with balance, inability to rise from a chair without using arms. The presence of three or more risk factors had a positive predictive value for a fall in the next 6 months of 0.57 (95 per cent confidence interval 0.43–0.69). Less than three risk factors had a negative predictive value of 0.86 (0.82–0.89), and a specificity of 0.92 (0.88–0.94). The tool may be useful for identifying people who would benefit from further assessment of their risk of falling and appropriate intervention.