Clinical Utility of Fall Risk Assessment Using the Japanese Anticholinergic Risk Scale

Abstract

Purpose: Falls among hospitalized patients significantly reduce their quality of life and increase healthcare costs. Anticholinergic drugs are recognized as key risk factors for falls. This study analyzed the relationship between falls and the Japanese Anticholinergic Risk Scale scores to provide clinical evidence.

Methods: Patients admitted between January 2022 and December 2023 were classified into fall and non-fall groups. Propensity score matching was adjusted for age, sex, body mass index, activities of daily living and disease. Fall risk was analyzed based on the Japanese Anticholinergic Risk Scale scores; low (1-2 points), moderate (3-4 points), and high (≥ 5 points). Logistic regression analysis was used to determine the odds ratios, and sensitivity and specificity were evaluated.

Results: Among the 19,739 patients, 310 matched cases were analyzed. Two scores of one point showed an odds ratio of 2.38 (p＝0.020). Risk increased in the low- (odds ratio; 1.71, p＝0.035) and moderate-risk groups (odds ratio; 2.18, p＝0.030), but stabilized in the high-risk group (odds ratio; 2.14, p＝0.170). Sensitivity was highest at four points (92%); however, specificity was low.

Conclusion: The Japanese Anticholinergic Risk Scale effectively predicted fall risk, especially moderate risk. However, fall risk did not increase proportionally with higher scores, suggesting that other factors influenced the outcomes. Comprehensive assessment of patient comorbidities is essential for effective fall prevention.