There are multiple physiological, environmental, and behavioural factors that can contribute to an individual’s risk of falling. Falls risk screening tools are valuable to guide health professionals in identifying an older adult’s risk of having a fall.
What makes a good screening tool?
There are many screening tools, making it challenging to know which one to choose.
The most common and easily implemented falls risk screening tools involve a series of questions asking, “have you had a fall in the last 12 months?” or “do you experience difficulties walking or maintaining your balance?” Many of these subjective screening tools have established validity and reliability.
It is important to recognise that a screening tool is not a falls prevention intervention, but rather a tool to identify those most at risk of falling. Screening tools are also a great way to start the discussion about falls prevention with older adults. Screening tools can also be retaken and used as an outcome measure to track improvements with interventions over time.
Commonly used Screening and Assessment Tools for use with Community Dwelling Older Adults
Falls Risk for Older People in the Community (FROP-Com)
The FROP-Com screening tool provides a comprehensive assessment of 13 risk factors for falls. The tool can assist in identifying an individual’s overall risk of having a fall as well as specific risk factors to target. The FROP-Com screen is a shortened version of the FROP-Com, assessing three common risk factors for falls. The FROP-Com screening tool is designed to be used by health professionals
The FROP-Com screen is a shortened version of the FROP-Com, assessing three common risk factors for falls. This is a more time effective tool and easier to implement, whilst still remaining a valid and reliable tool. It can be carried out by a health professional and support staff and is used to identify those at risk of falling and as a guide to referral.
Timed Up and Go (TUG) Test
The TUG Test is used to measure an individual’s function and gives an indication of dynamic balance. It does not require special equipment, and is recommended for use by a health professional. The test measures the time taken for the individual to stand up from a chair, walk three metres, and return to the chair and sit down. The TUG Test is well researched for validity and reliability and is often used in research studies.
The 30-Second and 5x Sit-to-Stand Tests require individuals to complete tasks involving standing up from a chair as quickly as possible without using hand support. The time taken to complete these movements or the number of movements completed provides an assessment of the individual’s lower limb strength, speed and coordination. The Sit-to-Stand Tests hold validity and reliability and are often used in research studies.
4-Stage Balance Test
Assessing an individual’s static balance, the 4-Stage Balance Test requires the individual to attempt four standing positions that get progressively more difficult to maintain. Once the individual is in the correct position (assisted if needed), they are instructed to maintain that position for 10 seconds before progressing onto the more challenging position. This test gives an indication of falls risk if these positions are not able to be maintained.
Cognitive screening tools
Assessing cognition is common when screening for falls risk and there are many cognition-focused screening tools available. If you are concerned about an individual’s fear of falling, rather than their overall cognitive capacity, Neuroscience Research Australia (NeuRA) has developed an app called icon-FES that uses pictures to assess the individual’s fear of falling.