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Table 1 Falls and fracture risk questionnaire for inclusion into the trial

From: Effectiveness of dual-task functional power training for preventing falls in older people: study protocol for a cluster randomised controlled trial

Risk factor

Guidelines

Score (circle)

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):

 
  1. aA fall is defined as an event that results in unintentionally coming to rest on the ground or a lower surface, other than as a consequence of a sudden onset of paralysis, epileptic seizure, or overwhelming external force.
  2. bA low trauma fracture is defined as a fragility fracture of the spine, hip or wrist.