ArticleFrontiers in public health2026
Predicting 90-day falls and unplanned medical visits in nursing home residents using rapid nursing scores including calf circumference, grip strength, Timed Up and go (TUG) test, weight change, and appetite: a prospective observational cohort study protocol.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Falls are the main health and safety threat faced by older adults in nursing homes, which can cause serious injuries and increase the risk of death. At present, there is a lack of simple fall risk screening tools that are applicable to the care practices of nursing homes and take into account both muscle function and nutritional status. Develop and validate a rapid scoring tool based on care accessibility indicators [calf circumference, grip strength, up/Walk timing Test (TUG), weight change and appetite] to predict the composite risk of falls or unplanned medical visits (emergency visits or unplanned hospitalizations) among older adults in care institutions within 90 days. Methods: This study was a prospective observational cohort study. It is planned to recruit approximately 500 older adults aged 65 and above from 10 nursing homes in Binzhou City, Shandong Province from September 2026 to November 2026 by using the convenience sampling method. Sociodemographic, clinical characteristics (history of falls, comorbidities), cognitive function and activities of daily living data were collected, and calf circumference, grip strength, TUG test, weight change (compared with at admission) and appetite (using a simplified nutritional appetite questionnaire) were measured. All participants in the group will be followed up for 90 days to monitor the occurrence of falls and unplanned medical visits. Univariate and multivariate Logistic regression analyses will be adopted to explore the association between each index and the composite outcome, and a predictive model will be constructed. The discrimination of the model will be evaluated by the area under the receiver operating characteristic curve (AUC), and the calibration will be evaluated by the Hosmer-Lemeshow test. It is planned to develop an integer scoring system based on the final model coefficients to facilitate the rapid application by front-line nursing staff. Discussion: This study aims to integrate simple indicators reflecting muscle structure, strength, dynamic function and nutritional status to construct a short-term risk assessment tool suitable for daily use in nursing homes. If verified to be effective, this scoring tool can help caregivers identify high-risk individuals at an early stage, implement targeted interventions in a timely manner, thereby reducing the incidence of falls and related adverse events, and improving the quality of care in nursing homes and the safety of older adults.
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