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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
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.