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14 - Fall Risk Screening and Assessment

from Part I - Epidemiology and Risk Factors for Falls

Published online by Cambridge University Press:  04 November 2021

Stephen R. Lord
Affiliation:
Neuroscience Research Australia, Sydney
Catherine Sherrington
Affiliation:
Sydney Medical School
Vasi Naganathan
Affiliation:
Concord Hospital
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Summary

As outlined in previous chapters, falls are not random events and are associated with multiple risk factors. Fall risk increases in line with the cumulative effect of impairments, making a multi-factorial risk assessment important. A risk assessment should include tests with proven validity and reliability in the relevant setting and population, and linked to appropriate, evidence-based interventions to reduce fall risk. This chapter discusses the relevance and role of fall risk screening and assessment and provides information about validated tools that can be used to measure fall risk in the community, hospitals, and residential aged care.

Type
Chapter
Information
Falls in Older People
Risk Factors, Strategies for Prevention and Implications for Practice
, pp. 227 - 236
Publisher: Cambridge University Press
Print publication year: 2021

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References

Panel on Prevention of Falls in Older Persons, American Geriatrics Society, and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148–57.Google Scholar
National Collaborating Centre for Nursing and Supportive Care. Clinical Practice Guideline for the Assessment and Prevention of Falls in Older People. London, UK: Royal College of Nursing (NICE); 2004.Google Scholar
American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49:664–72.Google Scholar
Podsialdo, D, Richardson, S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.Google Scholar
Schoene, D, Wu, SM, Mikolaizak, AS et al. Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis. J Am Geriatr Soc. 2013;61:202–8.Google Scholar
Tiedemann, A, Shimada, H, Sherrington, C et al. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing. 2008;37:430–5.Google Scholar
Guralnik, JM, Simonsick, EM, Ferrucci, L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49:M8594.Google Scholar
Lord, SR, Menz, HB, Tiedemann, A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83:237–52.CrossRefGoogle ScholarPubMed
Lord, SR, Delbaere, K, Gandevia, SC. Use of a physiological profile to document motor impairment in ageing and in clinical groups. J Physiol. 2016;594:4513–23.Google Scholar
Tiedemann, A, Lord, SR, Sherrington, C. The development and validation of a brief performance-based fall risk assessment tool for use in primary care. J Gerontol A Biol Sci Med Sci. 2010;65A:896903.CrossRefGoogle Scholar
Lord, SR, Ward, JA, Williams, P et al. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42:1110–17.Google Scholar
Lord, SR, Tiedemann, A, Chapman, K et al. The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized controlled trial. J Am Geriatr Soc. 2005;53:1296–304.Google Scholar
National Institute for Health and Care Excellence. Falls in Older People: Assessing Risk and Prevention. London, England: NICE; 2013.Google Scholar
Oliver, D. Falls risk-prediction tools for hospital inpatients: time to put them to bed?Age Ageing. 2008;37:248–50.Google Scholar
Haines, TP, Bennell, KL, Osborne, RH et al. A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting. J Clin Epidemiol. 2006;59:168–75.Google Scholar
Healey, F, Monro, A, Cockram, A et al. Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. Age Ageing. 2004;33:390–5.Google Scholar
Hill, AM, McPhail, SM, Waldron, N et al. Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial. Lancet. 2015;385:2592–9.CrossRefGoogle ScholarPubMed
Australian Commission on Safety and Quality in Health Care. Preventing Falls and Harm from Falls in Older People. Best Practice Guidelines for Australian Community Care. Sydney, NSW: ACSQHC; 2009.Google Scholar
Whitney, J, Close, JC, Lord, SR et al. Identification of high risk fallers among older people living in residential care facilities: a simple screen based on easily collectable measures. Arch Gerontol Geriatr. 2012;55:690–5.Google Scholar
Becker, C, Kron, M, Lindemann, U et al. Effectiveness of a multifaceted intervention on falls in nursing home residents. J Am Geriatr Soc. 2003;51:306–13.Google Scholar
Berg, KO, Wood-Dauphinee, SL, Williams, JI et al. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83:S711.Google ScholarPubMed
Franchignoni, F, Horak, F, Godi, M et al. Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 2010;42:323–31.Google Scholar
Verbaken, JH, Johnston, AW. Clinical contrast sensitivity testing: the current status. Clin Exp Optom. 1986;69:204–12.Google Scholar
Sherrington, C, Lord, SR. Reliability of simple portable tests of physical performance in older people after hip fracture. Clin Rehabil. 2005;19:496504.Google Scholar
Nasreddine, ZS, Phillips, NA, Bédirian, V et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.CrossRefGoogle Scholar
Inouye, SK, van Dyck, CH, Alessi, CA et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113:941–8.Google Scholar
Menant, JC, Meinrath, D, Sturnieks, DL et al. Identifying key risk factors for dizziness handicap in middle-aged and older people. J Am Med Dir Assoc. 2020;21:344–50.e2.Google Scholar
Yardley, L, Beyer, N, Hauer, K et al. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005;34:614–19.Google Scholar
Delbaere, K, Smith, ST, Lord, SR. Development and initial validation of the Iconographical Falls Efficacy Scale. J Gerontol A Biol Sci Med Sci. 2011;66:674–80.Google Scholar
Menz, HB, Sherrington, C. The Footwear Assessment Form: a reliable clinical tool to assess footwear characteristics of relevance to postural stability in older adults. Clin Rehabil. 2000;14:657–64.Google Scholar
Mackenzie, L, Byles, J, Higginbotham, N. Designing the Home Falls and Accidents Screening Tool (HOME FAST): selecting the items. Br J Occup Ther. 2000;63:260–9.Google Scholar
Clemson, L, Fitzgerald, MH, Heard, R. Content validity of an assessment tool to identify home fall hazards: The Westmead Home Safety Assessment. Br J Occup Ther. 1999;62:171–9.Google Scholar

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