Performance of retrospectively and prospectively-reported falls data in predicting future falls: results from the Falls in Glaucoma Study

Abstract Background Our objective is to investigate the association between prospectively-reported and retrospectively-reported falls data and the likelihood of subsequent falls in a cohort of patients with and without visual field loss. Methods Retrospective falls data (self-reported) was collected at the baseline visit where participants reported if they experienced a fall in the preceding year and their level of fear of falling. Prospective falls data (i.e. falls, near falls, and injurious falls) was collected using fall calendars with participants recording falls daily. Participants reported falls and near-falls monthly over a 2-year period. Logistic regressions assessed whether baseline retrospective falls data was predictive of falls in year 1 and whether prospective falls data in year 1 was associated with falls in year 2. Models were controlled for age, gender, race, degree of visual field (VF) loss, comorbidities, and polypharmacy. Results Fallers in the first year of study, as judged by prospective falls data, were 2.4 times (Odds Ratio (OR)=2.41, p=0.003) more likely to report a fall in the second year compared to non-fallers in the first year. Those who prospectively-reported more than one fall (OR=5.74, p-value<0.001), a single injurious fall (months 0 to 12; OR=2.30, p-value=.03), and multiple injurious falls (months 0 to 12; OR= 4.28, p-value=0.025) in year one were significantly more likely to report a fall in the following year. Self-report of a fall in the year preceding the study and fear of falling at baseline did not predict reporting falls in the first study year. Prospectively-reported near-falls in the first year were associated with higher odds of falls in both the first (concurrent) study year (OR=3.49, p<0.001) and the subsequent second year (OR=3.14, p<0.001). Predictive capacity of retrospective and prospective data to identify those at risk of falls in subsequent years did not vary by visual field sensitivity. Conclusions Prospectively-reported falls and near-falls are predictive of falls in subsequent years, while self-reported falls based on memory do not predict falls in subsequent years. These findings highlight the importance of prospective collection of falls data to accu­rately identify those at risk of falling who might benefit from fall prevention strategies. Trial registration Clinical trial number: not applicable