Functional continuum stratifies fall risk in older adults
Bibliographic record
Abstract
OBJECTIVES: Gait speed is a validated indicator of fall risk (Grade 1 A). However, accurate prevention requires comprehensive stratification indicators. The Functional Continuum (FC), which encompasses the full range of functional changes, shows promise for stratifying fall risk. METHODS: The study included 4,949 and 5,259 individuals from the National Health and Aging Trends Study (NHATS) wave 1 as the discovery sample, and 2,649 and 2,749 newly recruited individuals from wave 5 as the independent validation sample for the gait speed and FC analyses, respectively. RESULTS: At baseline, 19.2% of participants exhibited low gait speed; over follow-up, 66.2% sustained an incident fall. In the FC cohort, baseline distributions for levels 0–3 were 35.0%, 24.9%, 21.0%, and 19.1%, respectively, with 67.7% sustaining an incident fall. Both gait speed and FC function effectively stratified fall risk, with FC showing a significant dose-effect on fall risk. After adjusting for confounders, older adults with low gait speed had an increased fall risk (hazard ratio [HR]: 1.50, 95% confidence interval [CI]: 1.31, 1.71). The worse the FC, the higher the fall risk (Level 1: HR: 1.20, 95% CI: 1.06, 1.36; Level 2: HR: 1.63, 95% CI: 1.43, 1.87; Level 3: HR: 1.80, 95% CI: 1.54, 2.09). CONCLUSIONS: FC stratified fall risk into low-, medium-, and high-risk levels, offering a comprehensive, tiered framework for guiding prevention—from general exercise and monitoring in low-risk individuals to intensive measures in higher-risk groups. These findings highlight the potential utility of FC for optimizing resource allocation in fall prevention strategies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".