Aging & Health A to Z

Falls Prevention

Diagnosis & Tests

Evaluating a Fall or Risk of Falling

At your next regular check-up, talk with your healthcare professional about your risk of falling.

Describe any falls or close calls you’ve had, even if you weren’t hurt—in particular, if you’ve had two or more falls in the past twelve months, or if you have trouble walking. Your provider will want to know what caused you to fall, in order to prevent another one in the future. He or she will ask what you were doing when you fell, how you felt before the fall (for example, if you were dizzy or lightheaded?), whether you lost consciousness, and when and where it happened. Information about lighting, footwear, floor clutter, railings, and other environmental factors are all important.

Your healthcare professional will evaluate your gait and balance first, and ask you about risk factors. Alternately, you might be referred to a specialist, such as a physical therapist, who can assess your fall risk. If your healthcare professional concludes that you are at risk, he or she will follow up with a complete history and a physical exam, with attention to:

• Gait
• Balance
• Mobility (your ability to move around)
• Ability to carry out activities of daily living (for example, dressing and bathing)
• Blood pressure and postural hypotension (low blood pressure when you stand up)
• Heart rate and rhythm
• Vision
• Muscle strength and tone
• Reflexes and nerve health
• Review of medications taken and consumption of alcohol
• Foot health and footwear
• Diet
• Pain
• Joint stiffness (arthritis)
• New or chronic illnesses
• Your fear of falling and your mood
• Memory and brain functioning
• Risks in your home environment.

Tests

Your healthcare provider may also order blood and urine tests to check for things like electrolyte balance and the possibility of infection. You may also be evaluated using the “Get Up and Go” test, the Berg Balance Scale, or similar simple tests of mobility and balance. In these tests, you will be asked to get up from a chair, walk, turn, and sit down again; reach for something; or pick up an object from the floor.

Other tests may be ordered, including:

• Bone densitometry: to assess bone strength
• Heart assessments such as echocardiography
• Brain imaging such as CT scans or x-rays: if there has been a head injury, or if nerve disorders are suspected
• Drug levels if the review of medications reveals possible toxic levels
• Detailed memory testing
• Physical therapy assessment
• A home safety evaluation.

Updated: March 2012
Posted:  March 2012