Falls in the elderly

For a quick fall risk assessment, use the ‘timed up and go’ test.  Time the person in rising from a chair, walking 3m at their normal speed (with assistive device if they normally use one), turning, walking back, and sitting down again.  If this takes >12s, it indicates increased risk of falling.

Patients who have had two or more falls in the previous year are at higher risk and should have a more detailed assessment.  The ‘more detailed assessment’ recommended was the QuickScreen, which requires a low-contrast visual chart, a tactile filament, and a step 18 cm high, and takes ten minutes, meaning that if you add in any time for chatting to or listening to the patient you’re going to be running late.  I have a feeling that this is one that’s going to prove a bit more problematical outside the research setting.

Ask about spectacles (bifocals not recommended for when out and about as increase falls risk – tell them to wear single-lens glasses).  Consider Vitamin D supplementation, which reduced falls rates in a Cochrane review.

(This came from the BMJ of 17th Sept, article ref BMJ 2011;343:d5153.  )

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About Dr Sarah

I'm a GP with a husband and two young children.
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