International Journal of Clinical Case Reports, 2025, Vol.15, No.5, 200-208 http://medscipublisher.com/index.php/ijccr 202 Although these tools are widely used, their predictive effects vary greatly. Most studies have found that the area under the curve (AUC) of these tools ranges from 0.5 to 0.7, indicating that they can only reach a medium level. The sensitivity and specificity vary greatly among different studies and populations, indicating that no single tool can completely and accurately identify all high-risk groups. Therefore, clinical guidelines generally recommend the combined use of multiple tools and clinical judgment to enhance the reliability of fall risk identification among the elderly in the community (Strini et al., 2021; Jepsen et al., 2022). 3.2 Main contents and evaluation aspects of each tool The Morse Fall Scale (MFS) consists of six items: fall history, combined diagnosis, use of assistive devices, intravenous therapy, gait, and mental state. Each project has a score, and the total score represents the degree of risk. The higher the score, the greater the risk (Cai et al., 2025; Li et al., 2025). The Tinetti Balance Assessment (POMA) scores balance and gait respectively by observing actions such as sitting, standing, turning and walking, thereby comprehensively understanding the activity ability and stability of the elderly (Meekes et al., 2021). The Hendrich II fall risk model examines mental state, depression, excretory changes, dizziness, gender, the use of specific drugs (such as antiepileptic drugs or benzodiazepines), and performance in the "stand-up walk" test (Cho et al., 2020). Other methods such as BBS evaluate static and dynamic balance through multiple action tasks; The TUG test reflects the overall activity level by measuring the time required to stand up, walk, turn around and sit down. The fall history tool only needs to ask about past fall situations and is a fast and effective screening method. Each tool focuses on different risk aspects. Some emphasize physical and functional factors, while others combine cognitive, medication and environmental factors (Meekes et al., 2021; Strini et al., 2021; Jepsen et al., 2022). 3.3 Advantages and disadvantages of tools These methods each have their own advantages. For instance, MFS, TUG and BBS can complete evaluations quickly without the need for special equipment, making them suitable for application in communities and primary care. Tinetti and the Balance Scale can simultaneously examine balance and gait, which is helpful for identifying multi-dimensional risks. The fall history tool is very simple and does not require professional training, making it suitable for large-scale screening (Meekes et al., 2021; Strini et al., 2021). But no method can maintain a very high prediction accuracy in all cases. Their sensitivity and specificity vary significantly, and most tools mainly focus on the physical aspect, easily neglecting environmental and psychological factors. In addition, products like MFS and Hendrich II were originally developed in hospital Settings. Their direct use in the community might not be entirely appropriate and some adjustments are needed (Xu and Li, 2025). Therefore, it is recommended that multiple tools be combined with clinical judgment to improve the accuracy and practical effect of the assessment of elderly people in the community (Jepsen et al., 2022). 4 Evaluate the Applicability of the Tools Among the Community Population 4.1 Reliability and validity: evidence from community-aged individuals Many studies have shown that fall risk assessment methods can achieve good reliability and validity among elderly people in the community. For instance, some tools, such as the revised "Stay Independent" manual, the Fall Risk Self-Assessment Form (FRSAS), and the EASY-Care standard, have demonstrated good internal consistency, test-retest reliability, and discriminative validity in community Settings, with Cronbach coefficients generally above 0.75. The intra-class correlation coefficient exceeded 0.9 (Shahrestanaki et al., 2022). These methods are usually short and easy to understand, and can be accomplished by individuals or with minimal assistance, making them suitable for application in large-scale community screening (Wang et al., 2022). Some traditional assessment methods have limited effectiveness when used in the community, mainly because they were originally designed for hospitals or clinical Settings. For instance, the predictive effects of these methods on the elderly in the community usually only reach a medium level (with AUC values mostly ranging from 0.6 to 0.7). The results may vary depending on the population and the environment. Therefore, it is necessary
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