Senior Fall Risk Assessment
The CDC STEADI-style screen — risk score, the timed test, and the fixes that cut falls 30%+
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Screening Score
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Risk Band
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Timed Test
The CDC STEADI-style screen — risk score, the timed test, and the fixes that cut falls 30%+
Falls are the leading cause of injury and injury death for adults 65+ — one in four falls each year, and a hip fracture is frequently the pivot point of late-life independence. The good news is unusually strong: fall risk is measurable in minutes and reducible by 20–30%+ with unglamorous, proven steps. This assessment adapts the CDC's STEADI screening questions, adds the timed up-and-go test, and maps every "yes" to its fix.
| Factor | Why it matters | The fix |
|---|---|---|
| Prior fall | The strongest predictor — doubles future risk | Everything below, plus telling the doctor (half of falls go unreported) |
| 4+ medications / sedatives / BP meds | The top chemical cause: dizziness, orthostatic drops | A brown-bag medication review — pharmacists do it free |
| Leg weakness (pushing up from chairs) | Strength is the engine of recovery from stumbles | Sit-to-stand practice, PT, tai chi (best trial evidence of any exercise) |
| Orthostatic lightheadedness | Standing BP drops cause 'gray-out' falls | Two-stage rising; doctor checks lying/standing BP |
| Vision / bifocals | Depth misjudgment, especially stairs | Annual exam; consider single-vision glasses for walking |
| Home hazards | Half of falls happen at home | The checklist: rugs, lighting, grab bars, stair rails, clear paths |
| Bathroom urgency at night | The 2am rush on dark floors | Nightlights, bedside commode if needed, evening fluid timing |
The Timed Up-and-Go: rise from a standard chair, walk 10 feet, turn, return, sit — timed. ≥12 seconds flags elevated risk (CDC threshold). It takes one minute, needs a stopwatch and tape measure, and gives the screening questions a physical anchor. Related quick checks clinicians use: the 30-second chair-stand count and the 4-stage balance test — a PT runs all three in one visit.
It's the single strongest predictor — and the most underreported: about half of older adults don't tell their doctor, fearing fuss or lost independence. The irony inverts reality: reporting triggers the interventions that PRESERVE independence.
Yes, measurably — fear leads to activity restriction, which weakens legs and balance, which raises risk: the spiral. The counter is supervised, progressive activity (PT or tai chi classes), which rebuilds both capacity and confidence.
Sleep aids and benzodiazepines top the list; then blood-pressure meds (orthostatic drops), opioids, some antidepressants and anticholinergics, and simply the interaction load of 4+ drugs. Nobody should stop meds solo — the brown-bag pharmacist review is the safe route.
Downstream tools: they mitigate consequences, not risk. Evidence is mixed on hip protectors (adherence), better for personal alarms (faster help = better outcomes — 'long lies' after falls are their own harm). Prevention layers rank first; response tech second.
Properly FITTED and prescribed aids reduce falls; borrowed, wrong-height, or reluctantly-unused aids don't. A PT fitting (covered by Medicare with referral) turns the aid from furniture into equipment.
Annually at low risk; after ANY fall, medication change, hospitalization or new dizziness otherwise. The score is a moving target in the right hands — that's the encouraging part.
Yes — answers never leave the browser; nothing is stored.
Ten questions, one timed walk, and the checklist — fall risk is the rare major health threat that yields to a weekend of home fixes and a standing exercise habit. Screen yearly, report every fall, and keep the rugs off the floor and the strength in the legs.