|
History of fallinga
|
Self-reported risk of falling (1 or more falls in past year)a
|
3
|
|
Age
|
>75 years
|
2
|
|
70 to 75 years
|
1
|
|
Low trauma fractureb or osteoporosis
|
Since age of 50 years (T-score < −2.5 SD at the hip or spine)
|
2
|
|
Difficulty when rising from a chair or toilet without using arms
|
When getting up from a chair or the toilet do you use your arms?
|
2
|
|
History of slipping or tripping
|
Have you had a slip or trip in the past year?
|
2
|
|
Medication use
|
How many medications are you currently taking? If four or more include as two points
|
2
|
|
Use of walking aid
|
Yes or No?
|
2
|
|
One psychoactive drug
|
Do you take any medications to treat anxiety, panic attacks or insomnia seizures?
|
1
|
|
On feet < 4 hours per day
|
Are you on your feet < 4 hours a day?
|
1
|
|
Multi-focal glasses
|
Do you wear multi-focal glasses?
|
1
|
|
Poor vision (for example, cataract, glaucoma)
|
Self-reported or assessed by primary care physician - Do you have cataract or glaucoma?
|
1
|
|
When walking
|
Do you ever have trouble walking or feeling unsteady on your feet?
|
1
|
|
Self-rated health as fair or worse compared to last year
|
Excellent/Good/Fair/Poor/Very poor (very poor = 1 point)
|
1
|
|
Thinness
|
Body mass index (BMI) < 20
|
1
|
|
High risk of vitamin D deficiency
|
In summer, ‘Do you spend < 10 minutes per day outdoors (with part of your body exposed to sunlight), without taking vitamin D supplements between the hours of 10am to 3 pm’?
|
1
|
|
OR
|
|
In winter, ‘Do you spend < 30 minutes per day outdoors (with part of your body exposed to sunlight), without taking vitamin D supplements’?
|
|
Total score (Include if score ≥ 3):
| |
