Discover Public Health · Aug 7, 2026
Assessing fall risk using performance-based measure and self-report tool among community-dwelling older adults in selected Local Government Areas in Lagos State
By OSUNDIYA OC, Bakre OD, Afolabi S et al.
Falls are a significant public health concern among older adults, contributing to injuries, loss of independence, and increased mortality. Despite international advancements in fall risk assessment, there is limited evidence comparing self-report and performance-based tools among community-dwelling older adults in Nigerian urban settings, particularly Lagos State, where environmental hazards and high population density may amplify risk. To evaluate and compare the fall risk classification of a performance-based measure (Timed Up and Go—TUG test) and a self-report tool (STEADI Questionnaire) in assessing fall risk among community-dwelling older adults in selected Local Government Areas (LGAs) of Lagos State. A cross-sectional analytic study using a purposive sampling technique which involved 323 older adults aged 60 years and above from Mushin, Surulere, and Ikorodu LGAs. Participants were screened using the Mini-Mental State Examination (MMSE ≥ 24) to confirm cognitive eligibility. Data was collected using a semi-structured socio-demographic and clinical profile questionnaire, the STEADI Fall Risk Checklist (Self-report tool), and the TUG test (Performance-based measure). Descriptive statistics (mean, standard deviation, frequency, percentage) and inferential statistics (Chi-square test, Pearson correlation) were performed using SPSS version 22.0, with significance set at p < 0.05. The STEADI classified 49.85% of participants as high risk for falls, while the TUG test identified 34.37% as at risk (≥ 13.5 s cutoff). A strong positive correlation was observed between the two tools ( r = 0.701, p < 0.0001). Significant associations were found between fall risk and older age (80+), being female, lower educational level, unemployment status, and history of previous falls ( p < 0.0001 for both tools). This study provides evidence that the level of fall risk among community-dwelling older adults in Lagos state is consistent with global estimates and there is a strong positive correlation between STEADI and TUG fall risk scores indicating they are complementary for fall risk evaluation, with significant socio-demographic and clinical associations highlighting the need for integrated assessments in Nigeria to enhance prevention and target high-risk groups.