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

J Public Health (Oxf). 2004 Jun;26(2):138-43. doi: 10.1093/pubmed/fdh132.


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 (0.82-0.89), 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.

Publication types

  • Validation Study

MeSH terms

  • Accident Prevention / methods
  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Geriatric Assessment / methods*
  • Humans
  • Interdisciplinary Communication
  • Logistic Models
  • Male
  • Pilot Projects
  • Primary Health Care / methods*
  • Risk Assessment / methods*
  • Risk Factors
  • Surveys and Questionnaires*
  • United Kingdom