Simple Balance and Mobility Tests Can Assess Falls Risk When Cognition Is Impaired (original) (raw)

Simple balance tests can help assess falls risk, particularly in cognitively impaired elderly who have elevated falls risk and might not accurately recall previous falls. In 2006, almost 500 million people worldwide were aged 65 years of age or older. The National Institute on Aging projects that by 2030, this number will increase to 1 billion and represent 1 of every 8 persons in the world. 1 Health problems of the elderly therefore constitute rapidly growing public health concerns. Falls are a particularly prevalent health problem among the elderly and are associated with significant morbidity and mortality. In the United States, among those aged 65-74, falls cause 48% of unintentional nonfatal injuries, and 23.4% of unintentional fatal injuries. 2 These proportions are even higher among those 75 years and older, in whom falls make up 71.2% of unintentional nonfatal injuries and 39.3% of unintentional fatal injuries. 2 More than a third of the population 65 years of age or older falls each year, and half of these falls are recurrent. 3 As the U.S. population ages, the total direct cost for falls is expected to be $43.8 billion by the year 2020. 4 Although falls are a preventable source of morbidity, health care utilization, and functional decline in older adults, only 34% of elderly patients receive any type of fall evaluation. 5,6 In 2001, an expert panel on falls prevention 7 recommended that all older patients in all health care settings be asked whether they have fallen in the past year, with affirmative responses triggering mobility testing using a measure such as the Get Up and Go (GUG) test. 8,9 New guidelines, updated in 2006 but still unpublished, recommend screening questions and risk assessment followed by multifactorial assessment in those identified as at risk for falls. 10 One key quality measure recommended in the Physician Quality Reporting Initiative (PQRI), Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.