Senior Fall Risk Assessment

Falls are the leading cause of injury and injury death for adults 65+ — one in four falls each year, and a hip fracture is frequently the pivot point of late-life independence. The good news is unusually strong: fall risk is measurable in minutes and reducible by 20–30%+ with unglamorous, proven steps. This assessment adapts the CDC's STEADI screening questions, adds the timed up-and-go test, and maps every "yes" to its fix.

The Risk Factors (Each One Modifiable)

The 12-Second Test Anyone Can Run

The Timed Up-and-Go: rise from a standard chair, walk 10 feet, turn, return, sit — timed. ≥12 seconds flags elevated risk (CDC threshold). It takes one minute, needs a stopwatch and tape measure, and gives the screening questions a physical anchor. Related quick checks clinicians use: the 30-second chair-stand count and the 4-stage balance test — a PT runs all three in one visit.

What the Evidence Ranks Highest

1. Exercise with balance challenge — tai chi and structured strength/balance programs cut falls ~20–30% in trials; the effect needs 2–3 sessions weekly, ongoing.
2. Medication review — deprescribing sedatives/hypnotics is among the highest-yield single interventions.
3. Home modification with an OT assessment — ~20% reduction, more for prior fallers.
4. Vision correction, vitamin D (if deficient), footwear — smaller singly, additive together.
5. The STEADI bundle at a doctor visit ties it together — and Medicare wellness visits cover fall screening explicitly.

How to Use the Assessment

1. Answer the ten questions honestly (with or for the person assessed); run the timed test if safe to do so — someone nearby, sturdy chair.
2. Read the band; every "yes" is an action item mapped in the note.
3. Moderate+: the pharmacist review and home checklist this week; High: the doctor conversation this month, with this score in hand.

Frequently Asked Questions

Why does one prior fall matter so much?

It's the single strongest predictor — and the most underreported: about half of older adults don't tell their doctor, fearing fuss or lost independence. The irony inverts reality: reporting triggers the interventions that PRESERVE independence.

Is fear of falling itself a risk factor?

Yes, measurably — fear leads to activity restriction, which weakens legs and balance, which raises risk: the spiral. The counter is supervised, progressive activity (PT or tai chi classes), which rebuilds both capacity and confidence.

Which medications are the usual suspects?

Sleep aids and benzodiazepines top the list; then blood-pressure meds (orthostatic drops), opioids, some antidepressants and anticholinergics, and simply the interaction load of 4+ drugs. Nobody should stop meds solo — the brown-bag pharmacist review is the safe route.

Are hip protectors, alarms or floor sensors worth it?

Downstream tools: they mitigate consequences, not risk. Evidence is mixed on hip protectors (adherence), better for personal alarms (faster help = better outcomes — 'long lies' after falls are their own harm). Prevention layers rank first; response tech second.

What about walkers and canes?

Properly FITTED and prescribed aids reduce falls; borrowed, wrong-height, or reluctantly-unused aids don't. A PT fitting (covered by Medicare with referral) turns the aid from furniture into equipment.

How often should we re-screen?

Annually at low risk; after ANY fall, medication change, hospitalization or new dizziness otherwise. The score is a moving target in the right hands — that's the encouraging part.

Is my information private?

Yes — answers never leave the browser; nothing is stored.

Ten questions, one timed walk, and the checklist — fall risk is the rare major health threat that yields to a weekend of home fixes and a standing exercise habit. Screen yearly, report every fall, and keep the rugs off the floor and the strength in the legs.