The slippery slope: reducing fall risk in older adults

Determining fall risk can be a daunting task for the busy clinician, but a simple set of questions and observations at each encounter with the patient can help. Rarely does a complete fall-risk evaluation have to be completed in one visit. Most patients will have a gradual or incremental decline and the evaluation can be performed over time. The clinician should ask the older patient at each visit if he or she has had a fall, is concerned about falling, or is concerned about balance or gait. The clinician should also take notice of the person's mobility at the time of each encounter and observe how the patient enters the office and the examination room. How did the person get on the examination table room? Did the person walk in independently or with the aid of a family member or office staff? By being vigilant in the evaluation of patients at each visit, the office practitioner can more easily identify subtle declines that may lead to disability, falls, and the potential injuries associated with falls. Once at-risk patients are identified, risk factors can be reduced or eliminated and ongoing exercise and fitness programs recommended.