Fall Risk Assessment and Prevention

Core Components of Fall Risk Assessment

A comprehensive fall risk assessment should include multifactorial risk assessment with comprehensive management of identified risks, exercise or physical therapy interventions, and vitamin D supplementation as these have demonstrated benefits in preventing falls in community-dwelling older adults 1, 2
Primary care clinicians should identify older persons at increased risk through assessment of key risk factors including history of falls, mobility problems, and performance on the timed Get-Up-and-Go test 2, 3
Annual screening is recommended for all adults aged 65 and older, as 30-40% of community-dwelling adults in this age group fall at least once per year 2, 4
The timed Get-Up-and-Go test is a feasible primary care screening tool - healthy adults over 60 should complete this in less than 10 seconds 5, 6

Exercise or physical therapy has shown moderate benefit in preventing falls with high certainty of evidence 3, 5
Vitamin D supplementation has moderate benefit in preventing falls with moderate certainty of evidence 3, 6
Studies show approximately 17% reduction in fall risk during 6-36 months of follow-up 6

Multifactorial risk assessment with comprehensive management should be covered despite small benefit, as it can identify patients who would benefit from targeted interventions 1, 9
Exercise and physical therapy programs should be prioritized in coverage policies as they show the strongest evidence for fall prevention 3, 5
Vitamin D supplementation should be covered as a preventive measure, particularly for those with deficiency 3, 6