About falls risk factors - Stay On Your Feet

This section defines risk factors and discusses why they are important in preventing falls.

• What are risk factors?
• Why are risk factors important?
• Common risk factors for falls

What are risk factors?

A risk factor is something that increases an older person's chance of falling ¹¹⁴. Falls commonly result from a combination of risk factors ⁷⁷ as 'the risk of falling increases with the number of risk factors that are present' ¹¹⁵. The number of risk factors increases as a person ages ¹¹⁵. Risk factors can be classified in a number of ways ⁵⁶. One of the well-known methods is to classify them as either personal (intrinsic) or environmental (extrinsic). Personal risk factors include individual characteristics such as age, gender, ability and health conditions ¹¹⁵. Environmental risk factors refer to hazards found in and around the home and in public places, such as uneven surfaces and the lack of hand or grab rails ¹¹⁵.

Why are risk factors important?

Identifying and modifying the risk factors that individuals and the whole community are exposed to can reduce the risk of falls ¹¹⁴. As falls are caused by a number of risk factors, it is necessary to identify and modify multiple risk factors at one time in order to effectively reduce falls. This is known as a multi-factorial approach. However, not all risk factors can be modified. For example, age is a falls risk factor that cannot be changed, whereas reduced lower limb strength is a falls risk factor that can be improved.

Common risk factors for falls

The Queensland Stay On Your Feet® Community Good Practice Guidelines lists the risk factors currently linked with falls according to their strength of association and the ability for the risk factor to be modified ⁵⁶. The risk factors considered to have a high association with falls, which are also modifiable, include:

• the fear of falling
• limitations in mobility and undertaking the activities of daily living
• impaired walking patterns (gait)
• impaired balance
• visual impairment
• reduced muscle strength
• poor reaction times
• use of multiple medications specifically benzodiazepines, antidepressants, anti-psychotics and psychoactive medications ⁵⁶.

At an individual level, health care professionals can identify risk factors using risk screening tools and risk assessment tools as appropriate. Falls risk screening is of no value if there is already an identified risk, and a falls risk assessment is of no value if interventions are not followed through with action ^{12, 56}.