The following is the result of a clinical study performed by the Greater Los Angeles VA Geriatric Research Education Clinical Center and is a validated fall risk self-assessment tool (Validating an evidence-based, self-rated fall risk questionnaire (FRQ) for older adults – ScienceDirect).
Questionnaire
Participants are asked to respond to each of the following questions and then rate themselves for their risk of falling. If the participant scores “4” or more “yeses”, they are at risk of failing and should discuss their self-test results with their doctor. Predictive results from a “yes” score is provided for each question.
YES | NO | Question & Predictive Result |
☐ | ☐ | I have fallen in the past year. People who have fallen once are likely to fall again. |
☐ | ☐ | I use or have been advised to use a cane or walker to get around safely. People who have fallen once are likely to fall again |
☐ | ☐ | Sometimes I feel unsteady when I am walking. Unsteadiness or needing support while walking are signs of poor balance. |
☐ | ☐ | I steady myself by holding onto furniture when walking at home. This is also a sign of poor balance. |
☐ | ☐ | I am worried about falling. People who are worried about falling are more likely to fall. |
☐ | ☐ | I need to push with my hands to stand up from the floor. This is a sign of weak leg muscles, a major reason for falling. |
☐ | ☐ | I have some trouble stepping up onto a curb. This is also a sign of weak leg muscles. |
☐ | ☐ | I often have to rush to the toilet. Rushing to the bathroom, especially at night, increases your risk of falling. |
☐ | ☐ | I have lost some feeling in my feet. Numbness in your feet can cause stumbles and lead to falls. |
☐ | ☐ | I take medicine that sometimes makes me feel light-headed or tired. Side effects from medicines can sometimes increase your risk of falling. |
☐ | ☐ | I take medicine to help me sleep or improve my mood. These medicines can sometimes increase your chance of falling. |
☐ | ☐ | I often feel sad or depressed. Symptoms like not feeling well or felling slowed down, are linked to falls. |
Conclusions
The Fall Risk Questionnaire (FRQ) goes beyond existing screening tools in that it is based on both evidence and clinical acceptability and has been initially validated with clinical examination data. A larger validation with longitudinal follow-up should determine the actual strength of the FRQ in predicting future falls.
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