Does the CDC Stay Independent questionnaire predict falls in older adults?
Answered November 2, 202610 sources
EvidenceCLimitedStudies in people with real weaknesses: small, short or conflicting trials, or observational studies only.
Only a little. In one small study that tracked falls, the questionnaire sorted people who fell from those who didn't only slightly better than chance. We don't know yet how well it predicts falls.
Who it's for
Older adults being screened for fall risk, as a first step only.
What to expect
Weak prediction of who falls; it flags many people who never fall.
Watch out for
Many false alarms, so a high score alone shouldn't decide care.
The questionnaire predicts falls only modestly
Each dot shows how well the questionnaire separated people who fell from those who did not, with a line for its likely range.
← WorseBetter →
No difference
Falls within 3 months after emergency visit0.64 (0.49 to 0.8)Clear improvement
A study followed 134 adults aged 60 and older for 3 months after an emergency department visit. Only 14 (10.4%) fell or had a fall injury. The 12-question Stay Independent score was a weak predictor (0.64 on a scale where 0.5 is a coin flip and 1.0 is perfect). The true value could be anywhere from about chance to fairly good, because few falls occurred3Observational study · 2022 · 134 peoplePredicting falls within 3 months of emergency department discharge among community-dwelling older adults using self-report tools versus a brief functional assessment.We found that self-report and functional assessments lack sufficient accuracy to be used in isolation in the ED. A neural network model using accelerometer features could be a promising modality but research is needed to externally validate these findings.Am J Emerg Med.
A diagnostic study of 190 adults aged 70 and older in Germany (telephone interviews) compared the questionnaire with a balance and walking test, not with later falls. It caught 95% of people with impaired balance but flagged 78% of everyone as at risk. Only about 1 in 3 people without impairment were correctly cleared5Study · 2025 · 190 peopleValidity of the German version of the Stay Independent Questionnaire applied by telephone interview: A diagnostic accuracy study.The German version of the Stay Independent Questionnaire is capable of identifying community-dwelling seniors aged 70 and older without impairment in standing and walking balance. The high sensitivity of the test allows excluding test-negative individuals from further investigation. A limitation of the questionnaire…PLoS One.
That study notes that, before it, no validation against later falls in a cohort had been reported5Study · 2025 · 190 peopleValidity of the German version of the Stay Independent Questionnaire applied by telephone interview: A diagnostic accuracy study.The German version of the Stay Independent Questionnaire is capable of identifying community-dwelling seniors aged 70 and older without impairment in standing and walking balance. The high sensitivity of the test allows excluding test-negative individuals from further investigation. A limitation of the questionnaire…PLoS One. The questionnaire was not extensively validated on its own, though the wider CDC program (STEADI) has been rated positively5Study · 2025 · 190 peopleValidity of the German version of the Stay Independent Questionnaire applied by telephone interview: A diagnostic accuracy study.The German version of the Stay Independent Questionnaire is capable of identifying community-dwelling seniors aged 70 and older without impairment in standing and walking balance. The high sensitivity of the test allows excluding test-negative individuals from further investigation. A limitation of the questionnaire…PLoS One.
A study of patient records compared three questions from this tool with a machine-learning model for predicting fall injuries. The questions scored 0.59, close to chance, and the computer model scored 0.762Observational study · 2024Improved accuracy and efficiency of primary care fall risk screening of older adults using a machine learning approach.The current method of questionnaire-based fall risk screening of older adults is suboptimal with redundant items, inadequate precision, and no linkage to prevention. A machine learning fall injury prediction method can accurately predict risk with superior sensitivity while freeing up clinical time for initiating…J Am Geriatr Soc.
In stroke patients, scores were higher than in healthy older adults and tracked with walking and balance tests. That shows the score reflects mobility, not that it predicts future falls10Study · 2024 · 100 peopleAssessing the fall risk with Stay Independent Questionnaire in people with stroke.The C-SIQ emerges as a reliable and valid tool for evaluating fall risk in individuals with stroke, showcasing strong correlations with key measures such as TUG times, 10 mWT, FMA-LE, BBS, ABC, SIS, CIM score, paretic ankle dorsiflexion strength, and 6 mWT distance. The C-SIQ demonstrated good test-retest reliability…Front Neurol.
Key studies
Study
Who
What it found
Study following people, 20223Observational study · 2022 · 134 peoplePredicting falls within 3 months of emergency department discharge among community-dwelling older adults using self-report tools versus a brief functional assessment.We found that self-report and functional assessments lack sufficient accuracy to be used in isolation in the ED. A neural network model using accelerometer features could be a promising modality but research is needed to externally validate these findings.Am J Emerg Med
134 older adults after an emergency visit
Weak prediction of falls over 3 months; only 14 falls
Diagnostic accuracy study, 20255Study · 2025 · 190 peopleValidity of the German version of the Stay Independent Questionnaire applied by telephone interview: A diagnostic accuracy study.The German version of the Stay Independent Questionnaire is capable of identifying community-dwelling seniors aged 70 and older without impairment in standing and walking balance. The high sensitivity of the test allows excluding test-negative individuals from further investigation. A limitation of the questionnaire…PLoS One
190 adults aged 70+ in Germany
Caught most balance problems; many false alarms; falls not tracked
Case-control study, 20242Observational study · 2024Improved accuracy and efficiency of primary care fall risk screening of older adults using a machine learning approach.The current method of questionnaire-based fall risk screening of older adults is suboptimal with redundant items, inadequate precision, and no linkage to prevention. A machine learning fall injury prediction method can accurately predict risk with superior sensitivity while freeing up clinical time for initiating…J Am Geriatr Soc
Older adults in primary care
Three questions barely beat chance for fall injuries
Cross-sectional study, 202410Study · 2024 · 100 peopleAssessing the fall risk with Stay Independent Questionnaire in people with stroke.The C-SIQ emerges as a reliable and valid tool for evaluating fall risk in individuals with stroke, showcasing strong correlations with key measures such as TUG times, 10 mWT, FMA-LE, BBS, ABC, SIS, CIM score, paretic ankle dorsiflexion strength, and 6 mWT distance. The C-SIQ demonstrated good test-retest reliability…Front Neurol
100 people with stroke, 49 healthy adults
Scores matched mobility tests; no fall follow-up
Safety
No harms are reported for the questionnaire itself. The main risk is a false alarm leading to extra testing, or a low score giving false reassurance.
What we don't know
Whether it predicts falls over months to years in larger groups, since only one small study followed people forward for falls.
Whether it works better when combined with walking and balance tests, as is advised in practice.
Written by AI from the studies listed, without review by a clinician, and graded with the GRADE method. It can be wrong, so check the studies it cites. Education, not medical advice.