Development of the ADFICE_IT Models for Predicting Falls and Recurrent Falls in Community-Dwelling Older Adults: Pooled Analyses of European Cohorts With Special Attention to Medication

Bob van de Loo, Lotta J. Seppala, Nathalie van der Velde, Stephanie Medlock, Michael Denkinger, Lisette C. P. G. M. de Groot, Rose-Anne Kenny, Frank Moriarty, Dietrich Rothenbacher, Bruno Stricker, André Uitterlinden, Ameen Abu-Hanna, Martijn W. Heymans, Natasja van Schoor

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3 Citations (Scopus)


Background: Use of fall prevention strategies requires detection of high-risk patients. Our goal was to develop prediction models for falls and recurrent falls in community-dwelling older adults and to improve upon previous models by using a large, pooled sample and by considering a wide range of candidate predictors, including medications. Methods: Harmonized data from 2 Dutch (LASA, B-PROOF) and 1 German cohort (ActiFE Ulm) of adults aged ≥65 years were used to fit 2 logistic regression models: one for predicting any fall and another for predicting recurrent falls over 1 year. Model generalizability was assessed using internal-external cross-validation. Results: Data of 5 722 participants were included in the analyses, of whom 1 868 (34.7%) endured at least 1 fall and 702 (13.8%) endured a recurrent fall. Positive predictors for any fall were: educational status, depression, verbal fluency, functional limitations, falls history, and use of antiepileptics and drugs for urinary frequency and incontinence; negative predictors were: body mass index (BMI), grip strength, systolic blood pressure, and smoking. Positive predictors for recurrent falls were: educational status, visual impairment, functional limitations, urinary incontinence, falls history, and use of anti-Parkinson drugs, antihistamines, and drugs for urinary frequency and incontinence; BMI was a negative predictor. The average C-statistic value was 0.65 for the model for any fall and 0.70 for the model for recurrent falls. Conclusion: Compared with previous models, the model for recurrent falls performed favorably while the model for any fall performed similarly. Validation and optimization of the models in other populations are warranted.
Original languageEnglish
Pages (from-to)1446-1454
Number of pages9
Journaljournals of gerontology. Series A, Biological sciences and medical sciences
Issue number7
Early online date4 Apr 2022
Publication statusPublished - 1 Jul 2022


  • Accidental falls
  • Fall-risk-increasing drugs
  • Individual participant data
  • Prognosis

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