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): |  |