The INITIATE (Initial Test for Fall Risk Assessment in The Elderly) Prospective Cohort Study: Baseline Results

The INITIATE (Initial Test for Fall Risk Assessment in The Elderly) Prospective Cohort Study: Baseline Results | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The INITIATE (Initial Test for Fall Risk Assessment in The Elderly) Prospective Cohort Study: Baseline Results Stephanie Saunders, Ayse Kuspinar, Kathryn M Sibley, Cassandra D'Amore, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6490977/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 06 Dec, 2025 Read the published version in BMC Geriatrics → Version 1 posted 17 You are reading this latest preprint version Abstract Background Clinical practice guidelines (CPGs) for fall prevention recommend mobility or balance testing to identify older adults with high fall risk, who require further intervention. However, there is no consensus on the best tests or optimal cut-off values. The INITIATE study was designed to determine the optimal screening test(s) for predicting falls among community-dwelling older adults. Here we describe the study design, data collection, and baseline results. Methods We undertook a 1-year prospective cohort study of community-dwelling older adults (≥65 years) able to walk 10m without assistance at baseline and living in Ontario, Canada. Participants underwent a 2-hour baseline visit where 7 validated balance and mobility tests (Timed up and go (TUG) usual pace, TUG fast pace, TUG with a cognitive dual task, Brief-BESTest, chair stand, single leg stance, gait speed) were administered. Falls were tracked for 12 months using monthly diaries and follow-up calls for context. Participants received quarterly calls to monitor general wellbeing, healthcare utilization, and changes to mobility. Descriptive statistics were calculated and differences by 12-month fall history were tested using t-tests, chi square tests, and Wilcox Rank Sum tests as appropriate. Results From 3211 contacted older adults, 514 (19%) consented. The mean age was 76.4 years (SD 6.7), 64% were female, 68% had a postsecondary degree/diploma, and 231(45%) reported a fall in the last 12 months. Means(SD) for the performance-based tests were as follows: TUG = 11.8s(4.0), TUG fast pace = 9.2s(3.4), TUG cog = 14.2s(5.9), Brief BESTest = 15.9 score(5.3), chair rise = 12.5s(4.3), single leg stance = 14.1s(16.3), gait speed = 1.14 m/s(0.28). Comparisons between baseline fallers and non-fallers showed no differences in age, sex, income, or education (p>0.05) but did show differences in all 7 tests (p<0.05). Conclusions Participants in INITIATE had baseline characteristics and test performance scores that were comparable to those reported in Canadian population-based studies. Differences in the balance and mobility tests between fallers and non-fallers at baseline support the need for rigorous prospective comparisons of the predictive validity of tests. Follow-up results, expected in late 2025, will help inform future updates to fall risk assessment and prevention guidelines. falls aging community dwelling TUG mobility physical function balance Figures Figure 1 BACKGROUND Falls are the leading cause of injury-related hospitalization among older adults, resulting in substantial disability and early mortality. 1-3 Non-injurious falls have shown debilitating effects including fear of falling, reduced physical activity, and depression. 4 Due to the aging of the global population, the incidence of falls is expected to continue to rise, underscoring the importance of early fall risk detection for mitigating the impacts of falls. 2 There is an abundance of evidence demonstrating that falls can be prevented by as much as 20 to 40 5-7 %, by identifying modifiable fall risk factors and providing targeted interventions. Risk of falling is complex and multifactorial because of its intricate etiology that can involve interactions between many health conditions and an accumulation of age-related impairments in multiple systems. 8 While studies have identified hundreds of fall risk factors, previous falls and balance and mobility impairments have consistently emerged as the strongest independent risk factors. 9 Because poor balance is a leading risk factor for falls, balance and mobility testing are consistently recommended in clinical practice guidelines (CPGs) as part of fall risk assessment and prevention. 3, 10-13 Common to CPGs are multiple self-report screening processes designed to determine if further assessment is warranted (e.g., history of falls and injury). In cases where the fall risk is unclear, a clinical assessment for balance or mobility impairment is recommended. Those whose balance or mobility performance is below a pre-specified cut-off value should be referred for tailored interventions. However, differing guidelines recommend different tests, with little clarity on the specific test and/or cut-off values to use. For instance, the World Guidelines for Falls Prevention algorithm for fall risk stratification 3 recommend the gait speed test or the Timed Up and Go (TUG) test 14 , using cutoffs of 0.8m/s and >10 seconds, 15 respectively, to identify those at low or intermediate risk of future falls. In contrast, in the US Centre for Disease Control’s (CDC) fall prevention algorithm, STEADI (Stopping Elderly Accidents, Deaths, and Injuries) 16 , the TUG is recommended with a cutoff of 12 seconds to predict risk of future falls, whereas the UK’s NICE guidelines recommend any “assessment of balance and gait” 10 . The lack of consensus on specific tests and clinically meaningful cut-off values is likely related to the paucity of prospective studies examining the predictive validity of the screening tests and the absence of a gold standard method of assessing balance. 17 Systematic reviews have found that most tests report insufficient accuracy for predicting falls, have long administration times, and have not been validated in prospective studies. 18, 19 These shortcomings limit the uptake of CPGs for fall prevention and highlight the need to establish the predictive validity of clinically feasible short balance and mobility screening tools to inform evidence-based recommendations for fall risk screening. To address these gaps, we designed the INITIATE study to estimate the discriminant ability and optimal cut-off values of seven short mobility and balance screening tests for predicting falls in a community-dwelling sample of older adults. The primary aim of this report is to characterize the baseline attributes of the cohort and examine differences between individuals with and without a history of falls in the preceding 12 months. METHODS Study design A prospective cohort study conducted in a sample of n=514 community dwelling older adults (aged 65 years) from Ontario, Canada. Participants underwent a baseline assessment and were followed for 12 months via monthly fall diary postcards and phone interviews every 3 months. The study began in March 2020 with 17 participants but due to the COVID-19 pandemic recruitment was paused. Recruitment resumed in March 2022 until September 2023 with data collection completed in October 2024. The 12-month follow-ups for the first 17 participants were completed remotely as scheduled in 2021. The study received ethical approval from the Hamilton Integrated Research Ethics Board (#7380). Study sample and recruitment of participants Eligibility criteria were 1) ≥65 years; 2) community dwelling; 3) able to walk 10-metres without physical assistance from another person (gait aids were allowed); 4) able to attend the data collection site at McMaster University in Hamilton, Ontario; 5) able to communicate in English, and 6) to provide informed consent. Community dwelling was defined as not living in institutions that provide skilled care (i.e., hospitals, nursing homes, or assisted living facilities). We used a multi-pronged strategy to recruit participants. First, we randomly dialed publicly listed residential phone numbers provided by ASDE Solutions, a commercial sampling company. 20 Using 2016 Census data, we identified postal codes within the Hamilton area with the greatest proportion of adults aged 65 and older. These postal codes were submitted to ASDE Solutions, which generated a list of 10,000 phone numbers evenly distributed across the selected areas. For additional details on this method, see Beauchamp et al., 21 . Second, we recruited from a list of randomly sampled participants from previous studies led by the principal investigator (MKB) who had consented to be contacted for future studies. Finally, due to recruitment challenges related to the COVID-19 pandemic, we placed targeted newspaper and social media advertisements beginning in June 2023, midway through the study. These advertisements focused on demographic groups that were underrepresented in the sample, specifically men and individuals not born in Canada. Study procedures Participants completed a baseline assessment via phone or online surveys and a two-hour in-person physical assessment (details below). Prior to data collection, all assessors underwent 3 training sessions, supervised by the principal investigator who is a physiotherapist experienced with all tests (MKB), to ensure assessors followed Standard Operating Procedures. For 12-months after baseline, participants reported any falls each month via fall diary postcards, and every 3 months they took part in a phone interview, in line with the gold-standard PROFANE guidelines. 22 See Table S1 for the schedule of data collection and assessments. Study measures Fall outcomes. Our primary outcome is the number of falls participants experienced over 12 months of follow-up. Falls were defined as “an unexpected event in which the individual comes to rest on the ground, floor, or lower level”. 22 Participants recorded their falls in a fall diary on prepaid postcards that were mailed back to the research team monthly. If postcards were not received, the research team followed up with participants by phone. When falls were reported, the study team contacted participants to verify that the reported fall(s) met the definition, capture the circumstances surrounding the fall, and record any visits to a healthcare provider as a result of the fall. These phone calls also recorded injurious falls, which were classified based on symptoms as serious (fracture, requiring ER visit, or inpatient treatment), moderate (requiring healthcare examination) or minor (bruising/abrasion or reduction in physical function for at least 3 days with no health care visit). 23 In addition to the monthly diaries, participants engaged in a phone interview every three months to verify no falls went unreported on the postcards, complete global rating of change scales for general health and mobility, and report any healthcare utilization related to a fall (i.e., if they had a fall and had been receiving follow-up care). Performance based measures. Participants were asked to complete 7 balance and mobility measures wearing either flat shoes or, when wearing inappropriate footwear (i.e., boots, high heels), in bare feet. For measures that required a chair, we used a standard chair with arm rests and a seat height of 17.5 inches. Participants were permitted to use a gait aid for the walking tests if needed. No practice trials were given. The measures were administered in a random order to prevent ordering effects. We initially selected 6 tests based the following eligibility criteria to identify the most relevant tests for fall risk screening: 1) ≤10 minutes to administer (to ensure feasibility), and 2) at least one of the following: (i) recommended by a fall prevention CPG; or (ii) preliminary evidence supporting the measure’s predictive validity for falls (≥1 fall) from a prospective study of older adults. We added the Gait Speed test on June 7, 2023 when the World Falls Guidelines were published advocating for the use of gait speed as part mobility screening. This test was initially excluded based on literature showing poor predictive ability for falls among community dwelling older adults. 24, 25 The final included measures are listed below; for full psychometric properties of each measure see Table S2. TUG 14 usual pace: Participants start sitting in a chair and when the assessor says “go” they stand up, walk 3m at their normal pace, turn 180 degrees, return to the chair and sit. The time starts when the assessor says go and stops when the participant is sitting back down. A shorter time to complete this task indicates better mobility. The TUG is commonly used and is among the most widely cited in clinical practice guidelines. 16, 26, 27 TUG fast pace: Participants complete the TUG, but rather than walk at their normal pace, participants are asked to walk as quickly as they feel safe and comfortable without running. A shorter time to complete this task indicates better mobility. TUG with cognitive dual task (TUG cog) 28 : Participants start sitting and are asked to count backwards by 3 starting at 90. When they reach 84 the assessor says “go” and participants complete a TUG at their normal walking pace, all while continuing to count backwards. The assessor starts the timer when they say “go” and stops when participants sit back down. Shorter times indicate better performance. The test examines the cost of adding a cognitive demand onto a motor demand, since cognitive deficits are clearly associated with increased fall risk. 29, 30 Brief Balance Evaluation Systems Test (Brief-BESTest) 31 : The test assesses 6 components of the Systems Framework for Postural Control, with three components assessing both right and left sides. 31 The test takes approximately 10 minutes to complete, each item is scored 0 to 3 to a maximum score of 24, with higher scores indicating better balance. The 6 items assess biomechanical constraints (lateral leg lift), stability limits/verticality (reach forward), anticipatory postural adjustment (single leg stance), reactive postural response (compensatory step), sensory orientation (standing on foam with eyes closed), and stability in gait (timed up and go). The advantage of the Brief BESTest is its assessment of reactive postural control and verticality, as these are not typically included in balance assessments. 32 5 Repetition Chair-Stand Test: Participants start seated with their feet flat on the floor, then stand up and sit down five times as quickly as they can. The assessor starts timing when they say “go” and stops timing on the final stand. Participants may choose to use the arm rests. Shorter times indicate better balance and strength. 33, 34 This test is part of the CDC’s STEADI algorithm for assessing balance and risk for falls. 16 Single Leg Stance Test (SLS) 35 : Participants are asked to stand upright with their hands on their hips and lift one foot off the floor, bending the knee backwards, for as long as possible, to a maximum of 60s. Longer standing time indicates better static balance. Two trials are conducted on each leg, and participants were allowed to choose their preferred starting leg. This test is part of the STEADI assessment, 16 and is among the most commonly used balance test by clinicians. 36, 37 Gait Speed Test: Participants start standing and when instructed begin walking at their normal speed for a total of 7 meters (2 metres acceleration area, 3 metres measurement area, and 2 metres deceleration area). Assessors begin timing on the first footfall after the 2-metre acceleration zone and stop timing at the first footfall after the 3-metre walking area. Gait speed has shown excellent predictive validity for declining general health, however mixed results for predicting falls (AUCs=0.57 to 0.64). 24, 25 Descriptive and secondary variables. Measures were selected to capture key biological, behavioural, socioeconomic and environmental contributors to fall risk. Surveys asked about demographic background (e.g., age, sex, gender, race), socioeconomic status (e.g., income, education, residential dwelling), psychosocial wellbeing (e.g., social support, mood disorders, general wellbeing, fall self-efficacy), physical wellbeing (e.g., self-report function, mobility, hearing, vision), and environmental considerations (e.g., walkability, neighborhood characteristics). Physical measures included hearing audiometry, vision acuity, grip strength, height, weight, blood pressure, heart rate, foot sensation, and cognition. See Table S1 for schedule of data collection for all measures, Table S3 for psychometric properties, and supplementary file 1 for the physical assessment protocol. On July 13, 2023 due to changes in recognizing different gender statuses, we added an additional question asking more details about gender. Statistical analysis We report baseline descriptive statistics: means and standard deviations (SDs) for continuous parametric data, medians and interquartile ranges for non-parametric data, and frequencies and proportions for categorical data. To test for baseline differences between those who did and did not report falling in the previous 12-months we used t-tests, chi square tests, and Wilcoxon rank sum tests as appropriate. All analyses were undertaken using R (version 2024.04.2+764) with the level of statistical significance (2-tailed) set at 0.05. Sample size was calculated to meet the overall objective of INITIATE. RESULTS Recruitment and sample Sampling sources and study flow are shown in Figure 1. Of 2,785 individuals contacted by phone, 164 consented to participate. Another 426 individuals were recruited via advertisements or referrals from friends and family. Five hundred and fourteen participants consented and completed baseline assessments. On descriptive examination, those who did not complete the study appeared older, with lower education and poorer health status, and showed a higher proportion of male participants. Baseline characteristics Sociodemographic, health factors, and physical measures are reported in Table 1. The mean age of the sample was 76.4 years ( 6.7), more participants were female (n=328, 64%), 68% (n=349) had completed post-secondary education, and most were born in Canada (n= 373, 76%). In terms of general health status, participants rated themselves as having excellent/very good/good general health (n=436, 86%) and mental health (n=460, 89%). Almost all participants were taking a medication (n= 465, 91%), with a median of 3 (IQR=4) per day. In terms of mobility, 25% (n=126) used a gait aid, 45% (n=231) had fallen in the previous 12 months, and 100% (n=514) answered ‘yes’ to at least one of the World Falls’ Guidelines screening questions. 3 In comparing the sociodemographic characteristics between the sample recruited via random number lists (n=124) and via community advertisements (n=390), the random proportion of the sample was older (mean difference = 1.80 years, p=0.008) and had less education (p0.05). The descriptive statistics, sample sizes, and missing data for the balance and mobility tests are reported in Table 2. Two participants did not complete the entire assessment because they chose to leave prior to completion. Three participants were unable to understand the TUG cog test instructions and three refused to complete it. Researchers ended the session early for one participant due to a high blood pressure reading that was contra-indicated for the tests. One adverse event occurred where a participant experienced a fall during the Brief BESTest reactive postural response item. No injuries were reported and the participant did not seek medical attention. In comparing the baseline sociodemographic and participant characteristics between those who experienced a fall in the previous 12 months (n=231) and non-fallers (n=283), few characteristics were significantly different. Age, sex, education levels, and income were all similar between groups (p>0.05; Table 3). For self-report measures of mobility, there was a significant difference between fallers and non-fallers with respect to using a gait aid (p=0.002) and among those who felt unsteady with standing or walking (p<0.005). All performance-based mobility and balance tests were significantly different between fallers and non-fallers (p<0.05), however the magnitude of the differences were small and only TUG usual pace, single leg stance, and gait speed met MCID thresholds (Table 4). DISCUSSION The baseline results of this prospective cohort study indicate we are well positioned to conduct a comprehensive and rigorous examination of the predictive validity of different balance and mobility screening tests in community dwelling older adults. Notably, the overall sample closely resembled national cohorts, supporting the generalizability of our findings. 25 Further, our sample closely reflects community dwelling older adults targeted by current fall prevention CPGs. Although most sociodemographic characteristics did not differ between fallers and non-fallers, baseline differences in balance and mobility performance highlight the importance of evaluating these measures prospectively. Given the importance of generalizability in predictive validity research, we examined whether recruitment method influenced sample characteristics. Differences between randomly sampled and convenience groups were small, with only age and sex reaching statistical significance. In fact, our sample had similar distributions in age, self-rated health, and self-rated mental health to the population-based Canadian Longitudinal Study on Aging (CLSA). 25 With respect to fall rates, 45% of our sample had a fall in the previous 12 months, which is in line with commonly reported ranges between 15-50%. 1, 38 Regarding mobility testing, our sample also performed similarly on their baseline balance and mobility tests as participants from the CLSA. 25 Last, the entire sample answered “yes” to at least one standardized question assessing fall risk, indicating that the study sample is at risk for falls according to CPGs. There were no sociodemographic differences between fallers and non-fallers. While both age and sex have been suggested as important risk factors for falls in some studies 39 , this remains to be demonstrated unequivocally. 40, 41 In addition to the established question: “Have you had a fall in the past year”, the Worlds Falls Guidelines suggests asking “Do you feel unsteady with standing or walking?” and “Are you worried about falling?”. Interestingly, only the “feeling unsteady” question was able to differentiate between fallers and non-fallers at baseline. These brief self-report screening tests, along with others, 42 have not shown sufficient validity on their own for predicting falls; the importance of combining them with mobility tests remains to be assessed. Our baseline findings revealed that all balance and mobility tests differentiated between participants with and without a history of falling at baseline. This is not surprising given prior cross-sectional studies demonstrating similar results for many of the measures based on fall history. 19 However, it is notable that the magnitude of the between group differences was small and for most measures fell below previously established MCID values. The three tests that did meet these thresholds, TUG, single leg stance, and gait speed, are among the most commonly used tests, however the evidence remains inconsistent on whether or not these tests are sufficiently accurate for predicting future falls. 43 These findings underscore the need to evaluate their predictive validity longitudinally. Strengths and limitations The strengths of the INITIATE study include its prospective design with the inclusion of multiple commonly used tests of mobility and balance, the comprehensive assessment of other fall-related factors, and the rigorous falls tracking method. The limitations of this study include possible healthy volunteer bias for the majority of participants recruited via flyers, the split of the data between 2020 and 2022, the addition of gait speed later in the study, and the low proportion of participants born outside of Canada. Conclusion To our knowledge, this is the first prospective cohort study designed to directly compare different performance-based measures of mobility and balance for predicting falls over 12-months. The sample is comparable to older community-dwelling adults who would be screened for fall risk under current fall prevention guidelines. Findings from INITIATE will have direct clinical and health policy relevance for informing fall risk assessment and prevention guidelines in community-dwelling older adults. Declarations Ethics approval and consent to participate This study was approved by the Hamilton Integrated Research Ethics Board (#7380). All participants provided informed consent to participate in the study. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Clinical trial number Not applicable. Competing interests The authors declare that they have no competing interests Funding Funding Declaration: This work was supported by Canadian Institutes of Health Research grant number PJT-165844. SS is supported by a CIHR Banting & Best Canada Graduate Scholarship – Doctoral award. AK TBD KMS holds a Canada Research Chair in Integrated Knowledge Translation in Rehabilitation Sciences CD is supported by a Banting Postdoctoral Fellowship award. TN None at present LEG is supported by the McLaughlin Foundation Professorship in Population and Public Health. PR holds the Endowed Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging. JR None at present MS None at present MB holds a tier 2 Canada Research Chair in Mobility, Aging and Chronic Disease and an Early Researcher Award from the Ministry of Colleges and Universities. Authors' contributions SS : Acquired the data, conducted analysis, interpreted data, and drafted the initial manuscript. AK : Co-conceived the study, designed the study, interpreted data, and revised the manuscript. KMS : Co-conceived the study, designed the study, interpreted data, and revised the manuscript. CD : Acquired the data, supported the analysis, interpreted data, and revised the manuscript. TN: Acquired the data, and revised the manuscript LG : Designed the study, interpreted data, and revised the manuscript. PR : Designed the study, interpreted data, and revised the manuscript. JR : Designed the study, interpreted data, and revised the manuscript. MS : Designed the study, interpreted data, and revised the manuscript. 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Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada. Implementation science : IS 2013; 8 :33. Sibley KM, Straus SE, Inness EL, et al. Balance assessment practices and use of standardized balance measures among Ontario physical therapists. Phys Ther 2011; 91 :1583-91. Sibley KM, Voth J, Munce SE, et al. Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions. BMC geriatrics 2014; 14 :1-11. Saunders S, D'Amore C, Hao Q, et al. Risk factors for falls in community-dwelling older adults: An umbrella review. medRxiv 2025:2025.04.04.25325029. Deandrea S, Lucenteforte E, Bravi F, et al. Risk factors for falls in community-dwelling older people:" a systematic review and meta-analysis". Epidemiology 2010:658-68. Qian XX, Chen Z, Fong DY, et al. Post-hospital falls incidence and risk factors among older adults: A systematic review and meta-analysis. Age and ageing 2022; 51 :afab209. Burns ER, Lee R, Hodge SE, et al. Validation and comparison of fall screening tools for predicting future falls among older adults. Archives of gerontology and geriatrics 2022; 101 :104713. Beck Jepsen D, Robinson K, Ogliari G, et al. Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. BMC geriatrics 2022; 22 :615. Tables Table 1. Baseline descriptive statistics: sociodemographic, health-related, falls, and physical measures DEMOGRAPHIC Age, mean (SD) 76.43 (6.7) 65-74, n (%) 218 (42) 75-84, n (%) 236 (46) 85+, n (%) 60 (12) Female sex, n (%) 328 (64) BMI, mean (SD) 28.1 (5.6) <25kg/m 2 , n (%) 156 (31) 25 kg/m 2 , n (%) 354 (69) Not reported, n (%) 4 (<1) Education, n (%) <Secondary school 31 (6) Secondary school graduation but no post-secondary education 51 (10) Some post-secondary education 83 (16) Post-secondary degree/diploma 349 (68) Income, n (%) <$20,000 13 (3) $20,000 or more but <$50,000 115 (22) $50,000 or more but < $100,000 210 (41) $100,000 or more, but <$150,000 94 (18) $150,000 or more 58 (11) Not reported 24 (5) Marital status, n (%) Single 34 (7) Married/living with a partner in common-law relationship 282 (55) Widowed 114 (22) Divorced or separated 62 (12) Not reported 22 (4) Born in Canada, n (%) 373 (76) Not reported 22 (4) HEALTH RELATED Self-reported health status, n (%) Excellent / very good / good 436 (86) Fair / poor 45 (9) Not reported 23 (5) Self-reported mental health status, n (%) Excellent /very good / good 460 (89) Fair / poor 30 (6) Not reported 24 (5) Mean number of diagnosed health conditions, mean (SD) 2.37 (1.88) Cataracts, n (%) 302 (59) Osteoarthritis, n (%) 230 (45) Hypertension, n (%) 217 (42) Cancer, n (%) 114 (22) Number of medications taken per day, median (IQR) 3 (4) Use a walking aid, n (%) 126 (25) FALLS Yes to at least 1 fall screening question, n (%) 514 (100) Fell 1 times previous 12 months, n (%) 231 (45) Unsteady w standing/walking, n (%) 270 (53) Worried about falling, n (%) 223 (43) Total number of falls previous 12 months, n 461 PHYSICAL MEASURES Blood pressures (systolic mmhg), mean (SD) 135.79 (19.83) Blood pressure (diastolic mmhg) , mean (SD) 74.68 (10.27) Not reported, n (%) 6 (1) Grip strength (kg), mean (SD) 27.45 (9.17) Not reported, n (%) 9 (2) Vision acuity (ETDRS Acuity Log Score) , mean (SD) 0.09 (0.14) Table 2. Baseline descriptive statistics: balance and mobility test results Measure N Missing (N) Mean (SD) Median (IQR) TUG usual pace (seconds) 514 0 11.79 (4.02) 10.62 (3.87) TUG fast pace (seconds) 511 3 9.23 (3.38) 8.31(2.95) TUG cog (seconds) 506 8 14.30 (5.92) 12.62 (6.26) Brief BESTest (score) 514 0 15.90 (5.32) 16.50 (7.00) Chair rise (seconds) 510 4 12.47 (4.27) 11.77 (4.49) Single leg stance (mean, seconds) 514 0 14.08 (16.32) 6.48 (17.00) Gait speed (metres/second)* 152 1 1.14 (0.28) 1.15 (0.36) Table 3. Comparison of baseline sociodemographic characteristics between fallers and non-fallers in the previous 12 months Sociodemographic Characteristics Full sample (n=514) Fall in previous 12-months p value No (n=283) Yes (n=231) Age, mean (SD) 76.43 (6.7) 76.2 (6.7) 76.7 (6.7) p=0.339 Gender, n (%) Female 328 (64) 182 (55) 146 (45) p=0.867 Male 186 (36) 101 (54) 85 (46) Education, n (%) <Secondary school 31 (6) 20 (65) 11 (35) p=0.308 Secondary school graduation but no post-secondary education 51 (10) 31 (61) 20 (39) Some post-secondary education 83 (16) 44 (53) 39 (47) Post-secondary degree/diploma 349 (68) 188 (54) 161 (46) Income, n (%) <$20,000 13 (3) 3 (23) 10 (77) p=0.161 $20,000 or more but <$50,000 115 (22) 66 (57) 49 (43) $50,000 or more but < $100,000 210 (41) 110 (52) 100 (48) $100,000 or more, but <$150,000 94 (18) 53 (56) 41 (44) $150,000 or more 58 (11) 36 (62) 22 (38) Not reported 24 (5) 15 (63) 8 (33) Gait aid, yes n (%) Yes 126 (25) 54 (43) 72 (57) p=0.002 No 388 (75) 229 (59) 159 (41) Unsteady with standing/walking n (%) . . . . Yes 270 (54) 125 (46) 145 (54) p<0.005 No 244 (46) 158 (65) 86 (35) Worried about falling, n (%) . . . . Yes 223 (43) 119 (53) 104 (47) p=0.557 No 291 (57) 164 (56) 127 (44) Table 4. Comparison of baseline balance and mobility tests between fallers and non-fallers in previous 12 months Balance and Mobility test Full sample (n=514) Mean (SD) Fall in previous 12-months Mean difference P value No (n=283) Mean (SD) Yes (n=231) Mean (SD) TUG usual pace (seconds) 11.79 (4.03) 11.18 12.52 1.34 p <0.005 TUG fast pace (seconds) 9.24 (3.39) 8.78 9.78 0.99 p <0.005 TUG cog (seconds) 14.24 (5.92) 13.69 15.05 1.36 p <0.05 Brief BESTest (score) 15.9 (5.32) 16.60 15.04 1.56 p <0.005 Chair rise (seconds) 12.47 (4.27) 11.97 13.08 1.11 p <0.005 Single leg stance (mean, seconds) 14.1 (16.3) 15.75 12.03 3.72 p <0.05 Gait speed (metres/second) 1.14 (0.28) 1.21 1.06 0.15 p <0.005 Additional Declarations No competing interests reported. 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flow\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6490977/v1/151682a58eb63d7e8129c413.jpg"},{"id":97724458,"identity":"dc6bef02-39d0-4d8a-87c6-8cbf2e228b09","added_by":"auto","created_at":"2025-12-08 16:12:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1526946,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6490977/v1/90a874e2-3a3e-4b9a-9586-43def577be03.pdf"},{"id":84275073,"identity":"53d92c75-6c36-4229-b3ed-1e000346a464","added_by":"auto","created_at":"2025-06-10 05:35:01","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":111953,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFiles.docx","url":"https://assets-eu.researchsquare.com/files/rs-6490977/v1/1a9021cb3e8fd1aed0628005.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The INITIATE (Initial Test for Fall Risk Assessment in The Elderly) Prospective Cohort Study: Baseline Results","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eFalls are the leading cause of injury-related hospitalization among older adults, resulting in substantial disability and early mortality.\u003csup\u003e1-3\u003c/sup\u003e Non-injurious falls have shown debilitating effects including fear of falling, reduced physical activity, and depression.\u003csup\u003e4\u003c/sup\u003e Due to the aging of the global population, the incidence of falls is expected to continue to rise, underscoring the importance of early fall risk detection for mitigating the impacts of falls.\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is an abundance of evidence demonstrating that falls can be prevented by as much as 20 to 40\u003csup\u003e5-7\u003c/sup\u003e%, by identifying modifiable fall risk factors and providing targeted interventions.\u0026nbsp;Risk of falling is complex and multifactorial because of its intricate etiology that can involve interactions between many health conditions and an accumulation of age-related impairments in multiple systems.\u003csup\u003e8\u003c/sup\u003e While studies have identified hundreds of fall risk factors, previous falls and balance and mobility impairments have consistently emerged as the strongest independent risk factors.\u003csup\u003e9\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Because poor balance is a leading risk factor for falls, balance and mobility testing are consistently recommended in clinical practice guidelines (CPGs) as part of fall risk assessment and prevention.\u003csup\u003e3, 10-13\u003c/sup\u003e Common to CPGs \u0026nbsp;are multiple self-report screening processes designed to determine if further assessment is warranted (e.g., history of falls and injury). In cases where the fall risk is unclear, \u0026nbsp;a clinical assessment for balance or mobility impairment is recommended. Those whose balance or mobility performance is below a pre-specified cut-off value should be referred for tailored interventions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever, differing guidelines recommend different tests, with little clarity on the specific test and/or cut-off values to use. For instance, the World Guidelines for Falls Prevention algorithm for fall risk stratification\u003csup\u003e3\u003c/sup\u003e\u0026nbsp; recommend the gait speed test or the Timed Up and Go (TUG) test\u003csup\u003e14\u003c/sup\u003e, using cutoffs of\u0026nbsp;\u0026nbsp;0.8m/s and \u0026gt;10 seconds,\u003csup\u003e15\u003c/sup\u003e respectively, to identify those at low or intermediate risk of future falls. In contrast, in\u0026nbsp;the US Centre for Disease Control’s (CDC) fall prevention algorithm, STEADI (Stopping Elderly Accidents, Deaths, and Injuries)\u003csup\u003e16\u003c/sup\u003e, the TUG is recommended with a cutoff of\u0026nbsp;\u0026nbsp;12 seconds to predict risk of future falls, whereas the UK’s NICE guidelines recommend any “assessment of balance and gait”\u003csup\u003e10\u003c/sup\u003e. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe lack of consensus on specific tests \u0026nbsp;and \u0026nbsp;clinically meaningful cut-off values is likely related to the paucity of prospective studies examining the predictive validity of the screening tests and the absence of a gold standard method of assessing balance.\u003csup\u003e17\u003c/sup\u003e Systematic reviews have found that most tests report insufficient accuracy for predicting falls, have long administration times, and have not been validated in prospective studies.\u003csup\u003e18, 19\u003c/sup\u003e These shortcomings limit the uptake of CPGs for fall prevention and highlight the need to establish the predictive validity of clinically feasible short balance and mobility screening tools to inform evidence-based recommendations for fall risk screening. To address these gaps, we designed the INITIATE study to estimate the discriminant ability and optimal cut-off values of seven short mobility and balance screening tests for predicting falls in a community-dwelling sample of older adults. The primary aim of this report is to characterize the baseline attributes of the cohort and examine differences between individuals with and without a history of falls in the preceding 12 months.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA prospective cohort study conducted in a sample of n=514 community dwelling older adults (aged\u0026nbsp;\u0026nbsp;65 years) from Ontario, Canada. Participants underwent a baseline assessment and were followed for 12 months via monthly fall diary postcards and phone interviews every 3 months. The study began in March 2020 with 17 participants but due to the COVID-19 pandemic recruitment was paused. Recruitment resumed in March 2022 until September 2023 with data collection completed in October 2024. The 12-month follow-ups for the first 17 participants were completed remotely as scheduled in 2021. The study received ethical approval from the Hamilton Integrated Research Ethics Board (#7380).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy sample and recruitment of participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEligibility criteria were 1) \u0026ge;65 years; 2) community dwelling; 3) able to walk 10-metres without physical assistance from another person (gait aids were allowed); 4) able to attend the data collection site at McMaster University in Hamilton, Ontario; 5) able to communicate in English, and 6) to provide informed consent. Community dwelling was defined as not living in institutions that provide skilled care (i.e., hospitals, nursing homes, or assisted living facilities).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe used a multi-pronged strategy to recruit participants. First, we randomly dialed publicly listed residential phone numbers provided by ASDE Solutions, a commercial sampling company.\u003csup\u003e20\u003c/sup\u003e Using 2016 Census data, we identified postal codes within the Hamilton area with the greatest proportion of adults aged 65 and older. These postal codes were submitted to ASDE Solutions, which generated a list of 10,000 phone numbers evenly distributed across the selected areas. For additional details on this method, see Beauchamp et al., \u003csup\u003e21\u003c/sup\u003e. \u0026nbsp;Second, we recruited from a list of randomly sampled participants from previous studies led by the principal investigator (MKB) who had consented to be contacted for future studies. Finally, due to recruitment challenges related to the COVID-19 pandemic, we placed targeted newspaper and social media advertisements beginning in June 2023, midway through the study. These advertisements focused on demographic groups that were underrepresented in the sample, specifically men and individuals not born in Canada.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy procedures\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants completed a baseline assessment via phone or online surveys and a two-hour in-person physical assessment (details below). Prior to data collection, all assessors underwent 3 training sessions, supervised by the principal investigator who is a physiotherapist \u0026nbsp;experienced with all tests (MKB), to ensure assessors followed Standard Operating Procedures. For 12-months after baseline, participants reported any falls each month via fall diary postcards, and every 3 months they took part in a phone interview, in line with the gold-standard PROFANE guidelines.\u003csup\u003e22\u003c/sup\u003e\u0026nbsp; See Table S1 for the schedule of data collection and assessments.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy measures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFall outcomes.\u0026nbsp;\u003c/strong\u003eOur primary outcome is the number of falls participants experienced over 12 months of follow-up. Falls were defined as \u0026ldquo;an unexpected event in which the individual comes to rest on the ground, floor, or lower level\u0026rdquo;.\u003csup\u003e22\u003c/sup\u003e Participants recorded their falls in a fall diary on prepaid postcards that were mailed back to the research team monthly. If postcards were not received, the research team followed up with participants by phone. When falls were reported, the study team contacted participants to verify that the reported fall(s) met the definition, capture the circumstances surrounding the fall, and record any visits to a healthcare provider as a result of the fall. These phone calls also recorded injurious falls, which were classified based on symptoms as serious (fracture, requiring ER visit, or inpatient treatment), moderate (requiring healthcare examination) or minor (bruising/abrasion or reduction in physical function for at least 3 days with no health care visit).\u003csup\u003e23\u003c/sup\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eIn addition to the monthly diaries, participants engaged in a phone interview every three months to verify no falls went unreported on the postcards, complete global rating of change scales for general health and mobility, and report any healthcare utilization related to a fall (i.e., if they had a fall and had been receiving follow-up care).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePerformance based measures.\u0026nbsp;\u003c/strong\u003eParticipants were asked to complete 7 balance and mobility measures wearing either flat shoes or, when wearing inappropriate footwear (i.e., boots, high heels), in bare feet. For measures that required a chair, we used a standard chair with arm rests and a seat height of 17.5 inches. Participants were permitted to use a gait aid for the walking tests if needed. No practice trials were given. The measures were administered in a random order to prevent ordering effects. We initially selected 6 tests based the following eligibility criteria to identify the most relevant tests for fall risk screening: 1) \u0026le;10 minutes to administer (to ensure feasibility), and 2) at least one of the following: (i) recommended by a fall prevention CPG; or (ii) preliminary evidence supporting the measure\u0026rsquo;s predictive validity for falls (\u0026ge;1 fall) from a prospective study of older adults. We added the Gait Speed test on June 7, 2023 when the World Falls Guidelines were published advocating for the use of gait speed as part mobility screening. This test was initially excluded based on literature showing poor predictive ability for falls among community dwelling older adults.\u003csup\u003e24, 25\u003c/sup\u003e The final included measures are listed below; for full psychometric properties of each measure see Table S2.\u0026nbsp;\u003c/p\u003e\n\u003col class=\"decimal_type\"\u003e\n \u003cli\u003eTUG \u003csup\u003e14\u003c/sup\u003e usual pace: Participants start sitting in a chair and when the assessor says \u0026ldquo;go\u0026rdquo; they stand up, walk 3m at their normal pace, turn 180 degrees, return to the chair and sit. The time starts when the assessor says go and stops when the participant is sitting back down. A shorter time to complete this task indicates better mobility. The TUG is commonly used and is among the most widely cited in clinical practice guidelines.\u003csup\u003e16, 26, 27\u003c/sup\u003e \u0026nbsp;\u003c/li\u003e\n \u003cli\u003eTUG fast pace: Participants complete the TUG, but rather than walk at their normal pace, participants are asked to walk as quickly as they feel safe and comfortable without running. A shorter time to complete this task indicates better mobility.\u003c/li\u003e\n \u003cli\u003eTUG with cognitive dual task (TUG cog)\u003csup\u003e28\u003c/sup\u003e: Participants start sitting and are asked to count backwards by 3 starting at 90. When they reach 84 the assessor says \u0026ldquo;go\u0026rdquo; and participants complete a TUG at their normal walking pace, all while continuing to count backwards. The assessor starts the timer when they say \u0026ldquo;go\u0026rdquo; and stops when participants sit back down. Shorter times indicate better performance. The test examines the cost of adding a cognitive demand onto a motor demand, since cognitive deficits are clearly associated with increased fall risk.\u003csup\u003e29, 30\u003c/sup\u003e\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBrief Balance Evaluation Systems Test (Brief-BESTest)\u003csup\u003e31\u003c/sup\u003e: The test assesses 6 components of the Systems Framework for Postural Control, with three components assessing both right and left sides.\u003csup\u003e31\u003c/sup\u003e The test takes approximately 10 minutes to complete, each item is scored 0 to 3 to a maximum score of 24, with higher scores indicating better balance. The 6 items assess biomechanical constraints (lateral leg lift), stability limits/verticality (reach forward), anticipatory postural adjustment (single leg stance), reactive postural response (compensatory step), sensory orientation (standing on foam with eyes closed), and stability in gait (timed up and go). The advantage of the Brief BESTest is its assessment of reactive postural control and verticality, as these are not typically included in balance assessments.\u003csup\u003e32\u003c/sup\u003e\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e5 Repetition Chair-Stand Test: Participants start seated with their feet flat on the floor, then stand up and sit down five times as quickly as they can. The assessor starts timing when they say \u0026ldquo;go\u0026rdquo; and stops timing on the final stand. Participants may choose to use the arm rests. Shorter times indicate better balance and strength.\u003csup\u003e33, 34\u003c/sup\u003e This test is part of the CDC\u0026rsquo;s STEADI algorithm for assessing balance and risk for falls.\u003csup\u003e16\u003c/sup\u003e\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eSingle Leg Stance Test (SLS) \u003csup\u003e35\u003c/sup\u003e: Participants are asked to stand upright with their hands on their hips and lift one foot off the floor, bending the knee backwards, for as long as possible, to a maximum of 60s. Longer standing time indicates better static balance. Two trials are conducted on each leg, and participants were allowed to choose their preferred starting leg. This test is part of the STEADI assessment,\u003csup\u003e16\u003c/sup\u003e\u0026nbsp; and is among the most commonly used balance test by clinicians.\u003csup\u003e36, 37\u003c/sup\u003e\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGait Speed Test: Participants start standing and when instructed begin walking at their normal speed for a total of 7 meters (2 metres acceleration area, 3 metres measurement area, and 2 metres deceleration area). \u0026nbsp; Assessors begin timing on the first footfall after the 2-metre acceleration zone and stop timing at the first footfall after the 3-metre walking area. Gait speed has shown excellent predictive validity for declining general health, however mixed results for predicting falls (AUCs=0.57 to 0.64).\u003csup\u003e24, 25\u003c/sup\u003e\u0026nbsp;\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eDescriptive and secondary variables.\u0026nbsp;\u003c/strong\u003eMeasures were selected to capture key biological, behavioural, socioeconomic and environmental contributors to fall risk.\u0026nbsp;Surveys asked about demographic background (e.g., age, sex, gender, race), socioeconomic status (e.g., income, education, residential dwelling), psychosocial wellbeing (e.g., social support, mood disorders, general wellbeing, fall self-efficacy), physical wellbeing (e.g., self-report function, mobility, hearing, vision), and environmental considerations (e.g., walkability, neighborhood characteristics). Physical measures included hearing audiometry, vision acuity, grip strength, height, weight, blood pressure, heart rate, foot sensation, and cognition. See Table S1 for schedule of data collection for all measures, Table S3 for psychometric properties, and supplementary file 1 for the physical assessment protocol. On July 13, 2023 due to changes in recognizing different gender statuses, we added an additional question asking more details about gender.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe report baseline descriptive statistics: means and standard deviations (SDs) for continuous parametric data, medians and interquartile ranges for non-parametric data, and frequencies and proportions for categorical data. To test for baseline differences between those who did and did not report falling in the previous 12-months we used t-tests, chi square tests, and Wilcoxon rank sum tests as appropriate. All analyses were undertaken using R (version 2024.04.2+764) with the level of statistical significance (2-tailed) set at 0.05. Sample size was calculated to meet the overall objective of INITIATE.\u0026nbsp;\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eRecruitment and sample\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSampling sources and study flow are shown in Figure 1. Of 2,785 individuals contacted by phone, 164 consented to participate. Another 426 individuals were recruited via advertisements or referrals from friends and family. Five hundred and fourteen participants consented and completed baseline assessments. On descriptive examination, those who did not complete the study appeared older, with lower education and poorer health status, and showed a higher proportion of male participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBaseline characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSociodemographic, health factors, and physical measures are reported in Table 1. The mean age of the sample was 76.4 years (\u0026nbsp;6.7), more participants were female (n=328, 64%), 68% (n=349) had completed post-secondary education, and most were born in Canada (n= 373, 76%). In terms of general health status, participants rated themselves as having excellent/very good/good general health (n=436, 86%) and mental health (n=460, 89%). Almost all participants were taking a medication (n= 465, 91%), with a median of 3 (IQR=4) per day. In terms of mobility, 25% (n=126) used a gait aid, 45% (n=231) had fallen in the previous 12 months, and 100% (n=514) answered ‘yes’ to at least one of the World Falls’ Guidelines screening questions.\u003csup\u003e3\u003c/sup\u003e In comparing the sociodemographic characteristics between the sample recruited via random number lists (n=124) and via community advertisements (n=390), the random proportion of the sample was older (mean difference = 1.80 years, p=0.008) and had less education (p\u0026lt;.001) than the convenience sample. Other characteristics, including sex, income, and number of falls, were not significantly different (p\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003eThe descriptive statistics, sample sizes, and missing data for the balance and mobility tests are reported in Table 2. Two participants did not complete the entire assessment because they chose to leave prior to completion. Three participants were unable to understand the TUG cog test instructions and three refused to complete it. Researchers ended the session early for one participant due to a high blood pressure reading that was contra-indicated for the tests. One adverse event occurred where a participant experienced a fall during the Brief BESTest reactive postural response item. No injuries were reported and the participant did not seek medical attention.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; In comparing the baseline sociodemographic and participant characteristics between those who experienced a fall in the previous 12 months (n=231) and non-fallers (n=283), few characteristics were significantly different. Age, sex, education levels, and income were all similar between groups (p\u0026gt;0.05; Table 3). For self-report measures of mobility, there was a significant difference between fallers and non-fallers with respect to using a gait aid (p=0.002) and among those who felt unsteady with standing or walking (p\u0026lt;0.005). All performance-based mobility and balance tests were significantly different between fallers and non-fallers (p\u0026lt;0.05), however the magnitude of the differences were small and only TUG usual pace, single leg stance, and gait speed met MCID thresholds (Table 4).\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe baseline results of this prospective cohort study indicate we are well positioned to conduct a comprehensive and rigorous examination of the predictive validity of different balance and mobility screening tests in community dwelling older adults. Notably, the overall sample closely resembled national cohorts, supporting the generalizability of our findings.\u003csup\u003e25\u003c/sup\u003e Further, our sample closely reflects community dwelling older adults targeted by current fall prevention CPGs. Although most sociodemographic characteristics did not differ between fallers and non-fallers, baseline differences in balance and mobility performance highlight the importance of evaluating these measures prospectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGiven the importance of generalizability in predictive validity research, we examined whether recruitment method influenced sample characteristics. Differences between randomly sampled and convenience groups were small, with only age and sex reaching statistical significance. In fact, our sample had similar distributions in age, self-rated health, and self-rated mental health to the population-based Canadian Longitudinal Study on Aging (CLSA).\u003csup\u003e25\u003c/sup\u003e With respect to fall rates, 45% of our sample had a fall in the previous 12 months, which is in line with commonly reported ranges between 15-50%.\u003csup\u003e1, 38\u003c/sup\u003e\u0026nbsp; Regarding mobility testing, our sample also performed similarly on their baseline balance and mobility tests as participants from the CLSA.\u003csup\u003e25\u003c/sup\u003e Last, the entire sample answered “yes” to at least one standardized question assessing fall risk, indicating that the study sample is at risk for falls according to CPGs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere were no sociodemographic differences between fallers and non-fallers. While both age and sex have been suggested as important risk factors for falls in some studies\u003csup\u003e39\u003c/sup\u003e, this remains to be demonstrated unequivocally.\u003csup\u003e40, 41\u003c/sup\u003e In addition to the established question: “Have you had a fall in the past year”, the Worlds Falls Guidelines suggests asking “Do you feel unsteady with standing or walking?” and “Are you worried about falling?”. Interestingly, only the “feeling unsteady” question was able to differentiate between fallers and non-fallers at baseline. These brief self-report screening tests, along with others,\u003csup\u003e42\u003c/sup\u003e have not shown sufficient validity on their own for predicting falls; the importance of combining them with mobility tests remains to be assessed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur baseline findings revealed that all balance and mobility tests differentiated between participants with and without a history of falling at baseline. This is not surprising given prior cross-sectional studies demonstrating similar results for many of the measures based on fall history.\u003csup\u003e19\u003c/sup\u003e However, it is notable that the magnitude of the between group differences was small and for most measures fell below previously established MCID values. The three tests that did meet these thresholds, TUG, single leg stance, and gait speed, are among the most commonly used tests, however the evidence remains inconsistent on whether or not these tests are sufficiently accurate for predicting future falls.\u003csup\u003e43\u003c/sup\u003e\u0026nbsp; These findings underscore the need to evaluate their predictive validity longitudinally.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and limitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe strengths of the INITIATE study include its prospective design with the inclusion of multiple commonly used tests of mobility and balance, the comprehensive assessment of other fall-related factors, and the rigorous falls tracking method. The limitations of this study include possible healthy volunteer bias for the majority of participants recruited via flyers, the split of the data between 2020 and 2022, the addition of gait speed later in the study, and the low proportion of participants born outside of Canada.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eTo our knowledge,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ethis is the first prospective cohort study designed to directly compare different performance-based measures of mobility and balance for predicting falls over 12-months. The sample is comparable to older community-dwelling adults who would be screened for fall risk under current fall prevention guidelines. Findings from INITIATE will have direct clinical and health policy relevance for informing fall risk assessment and prevention guidelines in community-dwelling older adults.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cu\u003eEthics approval and consent to participate\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Hamilton Integrated Research Ethics Board (#7380). All participants provided informed consent to participate in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAvailability of data and materials\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eClinical trial number\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eCompeting interests\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eFunding\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u003c/strong\u003e This work was supported by Canadian Institutes of Health Research grant number PJT-165844.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSS\u0026nbsp;\u003c/strong\u003eis supported by a CIHR Banting \u0026amp; Best Canada Graduate Scholarship – Doctoral award.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAK TBD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKMS\u0026nbsp;\u003c/strong\u003eholds a Canada Research Chair in Integrated Knowledge Translation in Rehabilitation Sciences\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCD\u0026nbsp;\u003c/strong\u003eis supported by a Banting Postdoctoral Fellowship award.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTN\u0026nbsp;\u003c/strong\u003eNone at present\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLEG\u003c/strong\u003e is supported by the McLaughlin Foundation Professorship in Population and Public Health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePR\u0026nbsp;\u003c/strong\u003eholds the Endowed Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJR\u0026nbsp;\u003c/strong\u003eNone at present\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMS\u0026nbsp;\u003c/strong\u003eNone at present\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMB\u003c/strong\u003e holds a tier 2 Canada Research Chair in Mobility, Aging and Chronic Disease and an Early Researcher Award from the Ministry of Colleges and Universities.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAuthors' contributions\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSS\u003c/strong\u003e: Acquired the data, conducted analysis, interpreted data, and drafted the initial manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAK\u003c/strong\u003e: Co-conceived the study, designed the study, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKMS\u003c/strong\u003e: Co-conceived the study, designed the study, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCD\u003c/strong\u003e: Acquired the data, supported the analysis, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTN:\u0026nbsp;\u003c/strong\u003eAcquired the data, and revised the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLG\u003c/strong\u003e: Designed the study, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePR\u003c/strong\u003e: Designed the study, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eJR\u003c/strong\u003e: Designed the study, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMS\u003c/strong\u003e: Designed the study, interpreted data, and revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMB\u003c/strong\u003e: Conceived the study, designed the study, acquired the data, analyzed data, interpreted data, revised the manuscript, and supervised the first author.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAcknowledgements\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to acknowledge the following individuals for their support with data collection: Christina Ammerata, Evelyn Mejia, Raika Bourmand, Joanne Gorman, Nicholas Dietric, Savanna Malli, and Gurpal Deol.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eHaagsma JA, Olij BF, Majdan M, et al. 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Dual task interference in estimating the risk of falls and measuring change: a comparative, psychometric study of four measurements. \u003cem\u003eClinical rehabilitation\u003c/em\u003e 2010;\u003cstrong\u003e24\u003c/strong\u003e:831-42.\u003c/li\u003e\n \u003cli\u003eMuir SW, Gopaul K, Montero Odasso MM. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. \u003cem\u003eAge and ageing\u003c/em\u003e 2012;\u003cstrong\u003e41\u003c/strong\u003e:299-308.\u003c/li\u003e\n \u003cli\u003eBayot M, Dujardin K, Dissaux L, et al. Can dual-task paradigms predict Falls better than single task? \u0026ndash; A systematic literature review. \u003cem\u003eNeurophysiol Clin\u003c/em\u003e 2020;\u003cstrong\u003e50\u003c/strong\u003e:401-40.\u003c/li\u003e\n \u003cli\u003ePadgett PK, Jacobs JV, Kasser SL. Is the BESTest at its best? A suggested brief version based on interrater reliability, validity, internal consistency, and theoretical construct. \u003cem\u003ePhys Ther\u003c/em\u003e 2012;\u003cstrong\u003e92\u003c/strong\u003e:1197-207.\u003c/li\u003e\n \u003cli\u003eSibley KM, Beauchamp MK, Van Ooteghem K, et al. Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: A scoping review. \u003cem\u003eArch Phys Med Rehabil\u003c/em\u003e 2015;\u003cstrong\u003e96\u003c/strong\u003e:122-32 e29.\u003c/li\u003e\n \u003cli\u003eCsuka M, McCarty DJ. Simple method for measurement of lower extremity muscle strength. \u003cem\u003eAm J Med\u003c/em\u003e 1985;\u003cstrong\u003e78\u003c/strong\u003e:77-81.\u003c/li\u003e\n \u003cli\u003eLord SR, Murray SM, Chapman K, et al. Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. \u003cem\u003eThe journals of gerontology Series A, Biological sciences and medical sciences\u003c/em\u003e 2002;\u003cstrong\u003e57\u003c/strong\u003e:M539-43.\u003c/li\u003e\n \u003cli\u003eRossiter-Fornoff JE, Wolf SL, Wolfson LI, et al. A cross-sectional validation study of the FICSIT common data base static balance measures. Frailty and Injuries: Cooperative Studies of Intervention Techniques. \u003cem\u003eThe journals of gerontology Series A, Biological sciences and medical sciences\u003c/em\u003e 1995;\u003cstrong\u003e50\u003c/strong\u003e:M291-7.\u003c/li\u003e\n \u003cli\u003eSibley KM, Straus SE, Inness EL, et al. Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada. \u003cem\u003eImplementation science : IS\u003c/em\u003e 2013;\u003cstrong\u003e8\u003c/strong\u003e:33.\u003c/li\u003e\n \u003cli\u003eSibley KM, Straus SE, Inness EL, et al. Balance assessment practices and use of standardized balance measures among Ontario physical therapists. \u003cem\u003ePhys Ther\u003c/em\u003e 2011;\u003cstrong\u003e91\u003c/strong\u003e:1583-91.\u003c/li\u003e\n \u003cli\u003eSibley KM, Voth J, Munce SE, et al. Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions. \u003cem\u003eBMC geriatrics\u003c/em\u003e 2014;\u003cstrong\u003e14\u003c/strong\u003e:1-11.\u003c/li\u003e\n \u003cli\u003eSaunders S, D\u0026apos;Amore C, Hao Q, et al. Risk factors for falls in community-dwelling older adults: An umbrella review. \u003cem\u003emedRxiv\u003c/em\u003e 2025:2025.04.04.25325029.\u003c/li\u003e\n \u003cli\u003eDeandrea S, Lucenteforte E, Bravi F, et al. Risk factors for falls in community-dwelling older people:\u0026quot; a systematic review and meta-analysis\u0026quot;. \u003cem\u003eEpidemiology\u003c/em\u003e 2010:658-68.\u003c/li\u003e\n \u003cli\u003eQian XX, Chen Z, Fong DY, et al. Post-hospital falls incidence and risk factors among older adults: A systematic review and meta-analysis. \u003cem\u003eAge and ageing\u003c/em\u003e 2022;\u003cstrong\u003e51\u003c/strong\u003e:afab209.\u003c/li\u003e\n \u003cli\u003eBurns ER, Lee R, Hodge SE, et al. Validation and comparison of fall screening tools for predicting future falls among older adults. \u003cem\u003eArchives of gerontology and geriatrics\u003c/em\u003e 2022;\u003cstrong\u003e101\u003c/strong\u003e:104713.\u003c/li\u003e\n \u003cli\u003eBeck Jepsen D, Robinson K, Ogliari G, et al. Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. \u003cem\u003eBMC geriatrics\u003c/em\u003e 2022;\u003cstrong\u003e22\u003c/strong\u003e:615.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Baseline descriptive statistics: sociodemographic, health-related, falls, and physical measures\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDEMOGRAPHIC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge, mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e76.43 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e65-74, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e218 (42)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e75-84, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e236 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e85+, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e60 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale sex, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e328 (64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBMI, mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e28.1 (5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u0026lt;25kg/m\u003csup\u003e2 \u0026nbsp;\u003c/sup\u003e, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e156 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u0026nbsp;25 kg/m\u003csup\u003e2\u003c/sup\u003e , n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e354 (69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e4 (\u0026lt;1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u0026lt;Secondary school \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e31 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eSecondary school graduation but no post-secondary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e51 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eSome post-secondary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e83 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003ePost-secondary degree/diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e349 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u0026lt;$20,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e13 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e$20,000 or more but \u0026lt;$50,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e115 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e$50,000 or more but \u0026lt; $100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e210 (41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e$100,000 or more, but \u0026lt;$150,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e94 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e$150,000 or more\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e58 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e24 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e34 (7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eMarried/living with a partner in common-law relationship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e282 (55)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e114 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eDivorced or separated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e62 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e22 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBorn in Canada, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e373 (76)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Not reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e22 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHEALTH RELATED\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-reported health status, n (%)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eExcellent / very good / good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e436 (86)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eFair / poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e45 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e23 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-reported mental health status, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eExcellent /very good / good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e460 (89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eFair / poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e30 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e24 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean number of diagnosed health conditions, mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e2.37 (1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eCataracts, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e302 (59)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eOsteoarthritis, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e230 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eHypertension, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e217 (42)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eCancer, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e114 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of medications taken per day, median (IQR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e3 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUse a walking aid, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e126 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFALLS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes to at least 1 fall screening question, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e514 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eFell \u0026nbsp; 1 times previous 12 months, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e231 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eUnsteady w standing/walking, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e270 (53)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eWorried about falling, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e223 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal number of falls previous 12 months, n\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e461\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePHYSICAL MEASURES\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood pressures (systolic mmhg), \u0026nbsp;mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e135.79 (19.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood pressure (diastolic mmhg) , mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e74.68 (10.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e6 (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGrip strength (kg), \u0026nbsp;mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e27.45 (9.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003eNot reported, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e9 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.6869%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVision acuity (ETDRS Acuity Log Score) , mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.3131%;\"\u003e\n \u003cp\u003e0.09 (0.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Baseline descriptive statistics: balance and mobility test results\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp id=\"_Toc184664973\"\u003e\u003cstrong\u003eMeasure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMissing (N)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian (IQR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eTUG usual pace (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e514\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e11.79 (4.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e10.62 (3.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eTUG fast pace (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e9.23 (3.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e8.31(2.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eTUG cog (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e506\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e14.30 (5.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e12.62 (6.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eBrief BESTest (score)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e514\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e15.90 (5.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e16.50 (7.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eChair rise (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e12.47 (4.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e11.77 (4.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eSingle leg stance (mean, seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e514\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e14.08 (16.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e6.48 (17.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27.8351%;\"\u003e\n \u003cp\u003eGait speed (metres/second)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.27835%;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3711%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.6495%;\"\u003e\n \u003cp\u003e\u0026nbsp;1.14 (0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.866%;\"\u003e\n \u003cp\u003e\u0026nbsp;1.15 (0.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Comparison of baseline sociodemographic characteristics between fallers and non-fallers in the previous 12 months\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSociodemographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFull sample (n=514)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFall in previous 12-months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo (n=283)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes (n=231)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge, mean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e76.43 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e76.2 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e76.7 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003ep=0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e328 (64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e182 (55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e146 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 89px;\"\u003e\n \u003cp\u003ep=0.867\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e186 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e101 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e85 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u0026lt;Secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e31 (6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e20 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e11 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 89px;\"\u003e\n \u003cp\u003ep=0.308\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eSecondary school graduation but no post-secondary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e51 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e31 (61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e20 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eSome post-secondary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e83 (16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e44 (53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e39 (47)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003ePost-secondary degree/diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e349 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e188 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e161 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u0026lt;$20,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e13 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e10 (77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" style=\"width: 89px;\"\u003e\n \u003cp\u003ep=0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e$20,000 or more but \u0026lt;$50,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e115 (22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e66 (57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e49 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e$50,000 or more but \u0026lt; $100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e210 (41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e110 (52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e100 (48)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e$100,000 or more, but \u0026lt;$150,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e94 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e53 (56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e41 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e$150,000 or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e58 (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e36 (62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e22 (38)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eNot reported\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e24 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e15 (63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e8 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGait aid, yes n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e126 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e54 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e72 (57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep=0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e388 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e229 (59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e159 (41)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnsteady with standing/walking n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e270 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;125 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e145 (54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u0026lt;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e244 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e158 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e86 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWorried about falling, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 89px;\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e223 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e119 (53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e104 (47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 89px;\"\u003e\n \u003cp\u003ep=0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 425px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e291 (57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e164 (56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e127 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Comparison of baseline balance and mobility tests between fallers and non-fallers in previous 12 months\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"864\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 215px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBalance and Mobility test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 125px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFull sample (n=514)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFall in previous 12-months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean difference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo (n=283)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes (n=231)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eTUG usual pace (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e11.79 (4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e11.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e12.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eTUG fast pace (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e9.24 (3.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e8.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e9.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eTUG cog (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e14.24 (5.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e13.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e15.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eBrief BESTest (score)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e15.9 (5.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e16.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e15.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eChair rise (seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e12.47 (4.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e11.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e13.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eSingle leg stance (mean, seconds)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e14.1 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e15.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e12.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e3.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.05\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 215px;\"\u003e\n \u003cp\u003eGait speed (metres/second)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e1.14 (0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep \u0026lt;0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"falls, aging, community dwelling, TUG, mobility, physical function, balance","lastPublishedDoi":"10.21203/rs.3.rs-6490977/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6490977/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical practice guidelines (CPGs) for fall prevention recommend mobility or balance testing to identify older adults with high fall risk, who require further intervention. However, there is no consensus on the best tests or optimal cut-off values. The INITIATE study was designed to determine the optimal screening test(s) for predicting falls among community-dwelling older adults. Here we describe the study design, data collection, and baseline results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe undertook a 1-year prospective cohort study of community-dwelling older adults (≥65 years) able to walk 10m without assistance at baseline and living in Ontario, Canada. Participants underwent a 2-hour baseline visit where 7 validated balance and mobility tests (Timed up and go (TUG) usual pace, TUG fast pace, TUG with a cognitive dual task, Brief-BESTest, chair stand, single leg stance, gait speed) were administered. Falls were tracked for 12 months using monthly diaries and follow-up calls for context. Participants received quarterly calls to monitor general wellbeing, healthcare utilization, and changes to mobility. Descriptive statistics were calculated and differences by 12-month fall history were tested using t-tests, chi square tests, and Wilcox Rank Sum tests as appropriate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom 3211 contacted older adults, 514 (19%) consented. The mean age was 76.4 years (SD 6.7), 64% were female, 68% had a postsecondary degree/diploma, and 231(45%) reported a fall in the last 12 months. Means(SD) for the performance-based tests were as follows: TUG = 11.8s(4.0), TUG fast pace = 9.2s(3.4), TUG cog = 14.2s(5.9), Brief BESTest = 15.9 score(5.3), chair rise = 12.5s(4.3), single leg stance = 14.1s(16.3), gait speed = 1.14 m/s(0.28). Comparisons between baseline fallers and non-fallers showed no differences in age, sex, income, or education (p\u0026gt;0.05) but did show differences in all 7 tests (p\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants in INITIATE had baseline characteristics and test performance scores that were comparable to those reported in Canadian population-based studies. Differences in the balance and mobility tests between fallers and non-fallers at baseline support the need for rigorous prospective comparisons of the predictive validity of tests. Follow-up results, expected in late 2025, will help inform future updates to fall risk assessment and prevention guidelines.\u003c/p\u003e","manuscriptTitle":"The INITIATE (Initial Test for Fall Risk Assessment in The Elderly) Prospective Cohort Study: Baseline Results","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-10 05:34:56","doi":"10.21203/rs.3.rs-6490977/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-11T10:19:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-01T16:31:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-30T20:56:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-30T05:41:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135053654958070297058780475996181871857","date":"2025-07-17T00:03:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263991613095795526856567394907208085206","date":"2025-07-16T13:29:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"54771691824461083507353449421269188176","date":"2025-07-16T13:23:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"142113095300705995195983214864632733428","date":"2025-07-16T05:42:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"33964822199278529591501127509484933534","date":"2025-07-16T05:10:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122976914128575651408470338104539498791","date":"2025-07-16T01:12:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-29T22:27:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"262872152858983229980107669007563842509","date":"2025-06-19T12:43:36+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-04T04:23:04+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-06T08:08:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-28T09:33:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-28T09:27:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Geriatrics","date":"2025-04-20T20:21:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-geriatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bgtc","sideBox":"Learn more about [BMC Geriatrics](http://bmcgeriatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bgtc/default.aspx","title":"BMC Geriatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"88f921e8-8bf0-451c-9ac6-7eae1dcf8226","owner":[],"postedDate":"June 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T16:08:21+00:00","versionOfRecord":{"articleIdentity":"rs-6490977","link":"https://doi.org/10.1186/s12877-025-06724-9","journal":{"identity":"bmc-geriatrics","isVorOnly":false,"title":"BMC Geriatrics"},"publishedOn":"2025-12-06 15:58:28","publishedOnDateReadable":"December 6th, 2025"},"versionCreatedAt":"2025-06-10 05:34:56","video":"","vorDoi":"10.1186/s12877-025-06724-9","vorDoiUrl":"https://doi.org/10.1186/s12877-025-06724-9","workflowStages":[]},"version":"v1","identity":"rs-6490977","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6490977","identity":"rs-6490977","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}