ABSTRACT. Objectives. To develop a classification tree for predicting the risk of recurrent falling in community-dwelling older persons using tree-structured survival analysis (TSSA). Methods. This prospective cohort study was performed in 1365 community-dwelling persons (>=65 years) of the Longitudinal Aging Study Amsterdam (LASA). In 1995, physical, cognitive, emotional and social aspects of functioning were assessed. Subsequently, a prospective fall follow-up was conducted for three years. The main outcome measure was recurrent falls (two falls within six months). Results. The classification tree included eleven end groups differing in risk of recurrent falling based on a minimum of two and a maximum of six predictors. The first split in the tree involved two or more falls versus less than two falls in the year preceding the interview. Respondents with two or more falls in the year preceding the interview (n = 193), and with at least two functional limitations (n = 98) had 75 percent risk of becoming a recurrent faller, while respondents with less than two functional limitations were further divided into a group with regular dizziness (n = 11, risk of 68 percent) and respondents with no regular dizziness (n = 84, risk of 30 percent). In respondents with less than two falls in the year preceding the interview (n = 1172), the risk of becoming a recurrent faller varied between 9 to 70 percent. Predictors in this branch of the tree were low performance, low handgrip strength, alcohol use, pain, high level of education, and high level of physical activity. Conclusions. This classification tree included eleven end groups differing in the risk of recurrent falling based on specific combinations of maximally six easily measurable predictors. The classification tree can identify subjects who are eligible for preventive measures in public health strategies.
