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Abstract
Background: Falls are a common concern among older adults, a primary audiologic patient population. Hearing loss is common among individuals with a history of falls and fall injury. Community-dwelling audiology hearing clinic patients appear to be at a higher risk for falls than non-audiology patients.
Purpose: 1) To compare fall risk statistics and measures between community-dwelling audiology patients and non-audiology patients aged 60 years and older. 2) To develop and evaluate a preliminary fall risk screening protocol for use in audiology hearing clinics.
Methods: 1) Descriptive study with control group (n = 20 audiology patients, n = 20 non-audiology patients). Measures included: Activities-Specific Balance Confidence Scale, Dizziness Handicap Inventory (DHI), Generalized Anxiety Disorders-7, Hearing Handicap Inventory for the Elderly (HHIE), Timed Up and Go Test (TUG), and fall survey questions. Analyses included: Chi-Square Test of Independence, Fisher's Exact Test, and Mann-Whitney U Test.
2) Clinical utility analysis of all measures (n = 29 audiology patients, n = 23 non-audiology patients), including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios.
Results: 1) Lifetime prevalence of falls was 85.0% for both audiology and non-audiology patients. Audiology patients had a significantly higher annual incidence of falls (65.0%) than non-audiology patients (30.0%), χ 2 (1, N = 40) = 4.91, p = .027. Audiology patients had higher HHIE scores than non-audiology patients (U = 42.5, p < .001) and reported more chronic health problems (U = 126.0, p = .046).
2) A series positive protocol including the DHI, HHIE, number of medications, and the TUG test, in which two or more of the measures are positive, was most accurate in identifying audiology patients with a recent fall history (within 12 months).
Discussion: Falls are a significant problem for patients seeking hearing healthcare through audiology clinics. A simple, low cost, four-indicator series positive protocol with measures easily accessible to audiologists has good sensitivity (85%) and excellent specificity (100%) for identifying audiology patients with a recent fall history.
