Falls Prevention

Diagnosis & Tests

Evaluating a Fall or Risk of Falling

At your next regular check-up, talk with your healthcare provider 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 fall in the future. They will ask the following questions:

  • What were you doing when you fell?
  • How did you feel before the fall? For example, were you dizzy or lightheaded?
  • Did you lose consciousness?
  • When and where did the fall happen?

Your provider may also ask you about important environmental factors such as lighting, footwear, floor clutter, and railings.

Your healthcare provider 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 evaluate your fall risk. If your healthcare provider concludes that you are at risk, they 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 alcohol use
  • Foot health and footwear
  • Diet
  • Pain
  • Joint stiffness or arthritis
  • New or chronic illnesses
  • Your fear of falling
  • 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 that can impact your fall risk, such as electrolyte balance and the possibility of infection. You may also be evaluated using simple tests of mobility and balance such as the “Get Up and Go” test or the Berg Balance Scale. In these tests, you will be asked to reach for something, pick up an object from the floor, or get up from a chair, walk, turn, and sit down again.

Other tests may be ordered, including:

  • Bone densitometry (to assess bone strength).
  • Heart tests such as echocardiography, to find out if you have heart problems. Your provider may order these tests if you have had dizziness, fainting, or other symptoms related to heart problems.
  • Brain imaging such as CT scans or x-rays.  These are ordered if have had a head injury, or if nerve disorders are suspected.
  • Drug levels. These tests may be ordered if your provider reviewed your medications and found that they might be at toxic levels.
  • Detailed memory testing.
  • Physical therapy assessment.
  • A home safety evaluation.

 

Last Updated October 2017