Fall prediction using the Eight Alternative Touches test in older adults: a longitudinal study

Introduction: Falls among older adults represent a public health concern. Simple functional tools such as the Eight Alternative Touches test may contribute to the early identification of fall risk and support preventive strategies. The objective of this study was to investigate whether the Eight Alternative Touches test predicts the occurrence of falls in older adults over a one-year period.

Method: This longitudinal study included community-dwelling older adults followed for 12 months to record fall occurrences. At baseline, Eight Alternative Touches test, one of the items of the Balance Evaluation Systems Test (BESTest), was administered to assess anticipatory postural adjustments. Participants alternately touched a 10-cm-high foam surface with the tip of each foot, performing four touches per foot, as quickly as possible, with total time recorded in seconds. The study was approved by the Research Ethics Committee (CAAE: 36797720.6.0000.5440). Binary logistic regression was used to verify the association between fall occurrence during follow-up (yes/no) and test performance (time in seconds), adjusted for sex, age, physical exercise practice, multimorbidity, and history of falls in the previous 6 months. Analyses were performed using JASP software, with a significance level set at 5%.

Results: A total of 134 participated in the study, with a mean age of 67.53 (5.73) years; 88% were female. The mean number of falls during the 12-month follow-up was 1.17 (2.02). Logistic regression showed that longer completion time on the Eight Alternative Touches test was significantly associated with fall occurrence during follow-up (p = 0.03). Each additional second required to complete the test increased the odds of experiencing a fall within 12 months by 1.50 times (95% CI: 1.02–2.22).

Conclusion: The Eight Alternative Touches test demonstrated predictive ability for falls in older adults over a 12-month period, supporting its use as a simple functional tool for fall risk prediction.

Keywords: Older adults; Risk of Falls; Mobility