Development and preliminary examination of the predictive validity of the falls risk assessment tool (FRAT) for use in primary care

Sudip Nandy, Suzanne Parsons, Colin Cryer, Martin Underwood, Elaine Rashbrook, Yvonne Carter, Sandra Eldridge, Jacqueline Close, Dawn Skelton, Stephanie Taylor, Gene Feder*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

105 Citations (Scopus)


Background: 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. Methods: The tool was developed by an expert panel following the updating of an existing systematic review of community-based prospective studies identifying risk factors for falling and modified in accordance with the feedback from extensive piloting. We assessed predictive validity by a questionnaire survey sent at baseline and 6 months to a random sample of 1000 people aged over 65 in one Primary Care Group area. Results: 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 (0.8-0.89), and a specificity of 0.92 (0.88-0.94). Conclusion: The tool may be useful for identifying people who would benefit from further assessment of their risk of falling and appropriate intervention.

Original languageEnglish
Pages (from-to)138-143
Number of pages6
JournalJournal of Public Health
Issue number2
Publication statusPublished - Jun 2004
Externally publishedYes


  • Falls
  • Older people
  • Risk assessment


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