| Description: |
Background This study aimed to identify the predictive effects of different aspects of diabetic peripheral neuropathy (DPN) and other already known risk factors for falls through a comprehensive logistic model within community-dwelling older adults with diabetes and DPN. This paper also provides a model that estimates the probability of a fall occurring in a real-world clinical scenario. Methods This cross-sectional retrospective study analyzed data from subjects that had never fallen (non-fallers, n = 534) and that had fallen at least twice in the previous year (fallers, n = 101). The logistic regression analysis was performed on a training sample randomly extracted from the original sample (non-fallers: n = 85; fallers: n = 81). The model was validated by checking the performance parameters using a test sample comprised of 10% of fallers (n = 16) and a proportionate subsample of non-fallers (n = 85) from the original dataset. Results Three predictive models were developed. The best model (0.762 receiver operating characteristic[ROC] curve area, 60.4% accuracy, 68.8% sensitivity, 58.8% specificity) identified age (odds ratio[OR]=1.06[95%CI: 1.02, 1.10], P = 0.002), Michigan Neuropathy Screening Instrument score (OR=1.23[95%CI: 1.08, 1.40], P = 0.001), and self-reported balance problems (OR=2.65[95%CI: 1.29, 5.45], P = 0.008) as predictors of falls. A second model with good performance parameters (0.750 ROC curve area, 62.4% accuracy, 62.5% sensitivity, 62.4% specificity) showed that age (OR=1.04[95%CI: 1.01, 1.07], P = 0.015), balance problems (OR=3.29[95%CI: 1.64, 6.59], P = 0.001), and DPN severity (OR=1.18[95%CI: 1.03, 1.34], P = 0.018) were predictors of falls. Conclusions We showed the potential of a predictive model for recurrent falls based on commonly evaluated variables in community-dwelling individuals with diabetes for use in clinical practice. Even for individuals who are not at a high risk for falls, it is crucial to assess the combination of DPN signs, symptoms, and severity and the perception of ... |