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Self-Assessment on Fall Risk

Are you always worried about falling as you age?


Or has this never occurred to you?


A fall is defined as “an event that causes a person coming to rest on the ground or floor or other lower level”. It was estimated that there was a 30%-40% falls prevalence among older adults over the age of 65 years old. In Malaysian community-dwelling older adults aged over 60 years, falls incidence ranged between 15% to 34%. These figures corroborate with the global reports with one third/fourth older adults experiencing a fall annually. (Yoshida S. A et.al, 2007)


The American Geriatric Society has established the evidence-based clinical practice guidelines which encourages older adults to do medical screening for falls and a thorough diagnostic assessment to identify modifiable risks so that the risks of fall can be minimize.


Unfortunately, previous study shows that, majority of the community dwelling older adults underestimate the impact of fall even if they acknowledge the importance of fall prevention. Early fall prevention is also called as fall risk detection, it emphasises on the simple assessment tool from the view of cognitive, sensation, muscle strength, balance, comorbidities, falls history, medication intake and home evaluation hazards. (Romli MH et al., 2016)


However, the understanding of fall and its consequences among older adults in Malaysia is still inadequate. Although not all falls will have serious effects, in older adults, the effects may amplify greatly. In fact, when a fall incident happens to an older adult, they have a higher possibility of having a hip fracture, stroke, or laceration. Owing to the reduced metabolism and delayed healing process, longer recovery is required for them. Hence, secondary complications such as muscle weakness and cardiopulmonary function will be affected. Overall, a fall can cause reduced functional activities and thus reduce the quality of life of the patient as they may need assistive devices or help from others to accomplish activities daily living.






Risk factors of falls (Laurence Z et al., 2002)

  • Muscle weakness

  • History of falls

  • Gait deficit

  • Balance deficit

  • Use assistive device

  • Visual deficit

  • Arthritis Impaired ADL

  • Depression

  • Cognitive impairment

  • Age > 80 years


Therefore, keeping oneself in check to prevent recurrent falls is vital for the elderlies. You can assess yourself or request help from someone else. Here are ways to assess yourself.



Usually, older adults have multiple risk factors that require medical, physiotherapy management and adoption of new behaviours such as exercise. In conclusion, acknowledgement of the consequences of fall only is never enough; changing the behaviours toward fall is the key point. The execution of fall prevention should not be blamed on others but yourself as you are your own responsibility. Remember, prevention is always better than cure.






Reference:


Vivrette, R. L., Rubenstein, L. Z., Martin, J. L., Josephson, K. R., & Kramer, B. J. (2011). Development of a fall-risk self-assessment for community-dwelling seniors. Journal of aging and physical activity, 19(1), 16–29.


Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clinics in Geriatric Medicine. 2002;18(2):141–158.


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