Although falls are not an inevitable part of ageing, the likelihood of falling- and the frequency and severity of fall-related injuries increases with age. Fortunately, early identification through validated screening and assessment tools can help predict and prevent falls in older adults.
Why screen for falls risk?
Falls risk screening is a crucial first step in identifying individuals who may be at increased risk. It also guides clinicians in determining what further assessments are warranted. Comprehensive assessments help identify underlying causes such as balance impairments, muscle weakness, or environmental hazards, and inform targeted interventions. These might include structured exercise programs, referrals to specialist practitioners, or connections with community-based falls prevention services.
People may not always report falls
Many older adults, particularly males, are unlikely to volunteer information about a fall unless specifically asked. Research shows that fewer than one in three older men will mention a fall unless prompted. This highlights the importance of including opportunistic case finding as part of routine care.
The World Guidelines for Falls Prevention and Management for Older Adults endorses this approach, recommending that clients be routinely asked three simple questions:
- Have you fallen in the past year?
- Do you feel unsteady when standing or walking?
- Do you worry about falling?
The Australian Falls Guidelines for Community Care also recommend good practice points for falls risk screening and assessment. For example, the Guidelines recommend that older adults be asked every year about any falls and screened annually with a validated tool. A multidisciplinary approach should be taken for assessment, care coordination, and planning, as well as working with older adults to identify risks, set goals, and implement fall prevention interventions.
Valid assessments to guide prevention
Using validated tools to provide objective insights into an individual’s mobility, assists allied health professionals in assessing falls risk and designing appropriate interventions. Recommended screening and assessment tools such as:
- FROP-Com
- Sit-to-Stand tests
- 4-Stage Balance Test
- Cognitive screening tools
Start simple and act early
Routinely ask older clients the three key questions about falls. If risk is identified, follow up with a validated assessment tool and use the results to guide targeted interventions or referrals. Early, proactive conversations and assessments can prevent falls and support older adults to stay safe, independent, and active.