Elderly falls, multifactorial medical problem - how to assess the risk?

Paula Jankowska, Krzysztof Jankowski, Ewa Rudnicka-Drożak


Advanced age of a large part of society is associated with many health as well as social and economic consequences. Among them, disorders of mobility and falls of elderly have important place. The pathophysiology of falls among elderly is complex. It includes visual impairment, vestibular disorders, dementia, sarcopenia and use of many drugs. Screening for falls risk is essential part of everyday primary healthcare provider practice. Critical review of medications, management of chronic diseases may prevent falls. Apart from this, there are some professional functional assessment instruments available.
The objective of this work is to present reasons of elderly falls and functional assessment instruments suitable to assess risk of falls.
Among analyzed instruments Timed Up-and-Go test, Elderly Fall Screening Test, Tinetti Performance Oriented Mobility and Berg Balance Test were chosen to be described, due to the best characteristics according to needs of primary care.
Falls are important health problem in elderly. Frequently, falls result in serious injury and following disability. Consequences of elderly falls may be even fatal. Thus, healthcare providers should pay attention especially to modifiable risk factors of falls. Among them is polypharmacy and use of selected drug groups. The burden of coordination of patient treatment, critical review of administered drugs and systematic screening for increased falls risk lays on family doctors. The most suitable for primary healthcare setting instrument designed to address this aim, seems to Timed Up-and-Go test. Tools as Elderly Fall Screening Test, Tinetti Performance Oriented Mobility and Berg Balance Test can be used as well.


Aged; Falls; Risk

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Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701-1707.

O’Loughlin J, Robbitaille Y, Boivin J, et al. Incidence of and risk factors for falls and injurious falls among community-dwelling elderly. Am J Epidemiol. 1993;137:342–54.

Blake A, Morgan K, Bendall M, et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing. 1988;17:365–72.

Soriano TA, DeCherrie LV, Thomas DC. Falls in the community-dwelling older adult: a review for primary-care providers. Clin Interv Aging. 2007;2:545–554.

Edbom-Kolarz A., Marcinkowski J.T. Upadki osób starszych — przyczyny, następstwa, profilaktyka. Hygeria Public Health 2011; 46 (3): 313–318.

Lipsitz LA. Orthostatic hypotension in the elderly. N Engl J Med. 1989;321:952–7.

Berry SD, Miller RR. Falls: epidemiology, pathophysiology, and relationship to fracture. Curr Osteoporos Rep. 2008 Dec;6(4):149–154.

Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc. 1999 Jan;47(1):30–39.

Cumming RG. Epidemiology of medication-related falls and fractures in the elderly. Drugs Aging. 1998;12:43–53.

Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med. 1994 Sep 15;121(6):442–451.

Rigler SK. Preventing falls in older adults. Hospit Pract 1999, 34: 8-12.

Borzym A. Upadki osób w podeszłym wieku – przyczyny, konsekwencje i zapobieganie. Psychogeriatria Polska. 2009;6:81–88.

Duthie ER Jr. Falls. Med. Clin North America 1989; 73 (6): 1321-1336.

Delbaere K, Crombez G, Vanderstraeten G, Willems T, Cambier D. Fear-related avoidanceof activities, falls and physical frailty. A prospective community-based cohort study. Age Ageing2004; 33: 368-373.

, Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E. Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int. 2001;12(4):271–278.

D. Podsiadlo, S. Richardson, The Time “Up & Go”: A test of basic functional mobility for frail elderly persons, J. Amer. Geriatr. Soc. 39 (1991), 142-148.

Perell, K.L., Nelson, A., Goldman, R.L. et al, Fall risk assessment measures: an analytic review.J Gerontol. 2001;56A:M761–M766.

Cwikel JG, Fried AV, Biderman A, Galinsky D. Validation of a fallrisk screening test, the Elderly Fall Screening Test (EFST), for community-dwelling elderly. Disabil Rehabil. 1998;20:161–167.

Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities.Am J Med.1986;80:429–434.

Berg K. Balance and its measure in the elderly: a review. Physiother Can.1989;41:240–246.

DOI: http://dx.doi.org/10.5281/zenodo.1326392


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