Fall Risk

Fall risk assessment in geriatric patients requires a multidimensional approach that goes beyond a single screening tool. The NP performs a COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) that evaluates multiple interacting domains contributing to fall risk. GAIT AND BALANCE: age-related changes (sarcopenia, decreased proprioception, vestibular decline, slowed righting reflexes) combined with pathological conditions (Parkinson's disease, peripheral neuropathy, stroke, osteoarthritis, spinal stenosis) create compound gait impairment. Validated assessment tools include: Timed Up and Go (TUG) -- ≥12 seconds indicates impaired mobility; 30-Second Chair Stand Test -- evaluates lower extremity strength; 4-Stage Balance Test (feet together, semi-tandem, tandem, single-leg) -- inability to hold tandem for 10 seconds indicates balance impairment; gait speed -- <0.8 m/s predicts falls, hospitalization, and mortality. COGNITION: executive function impairment (planning, attention, dual-tasking) is a STRONGER predictor of falls than memory impairment; cognitive-motor dual-task testing (walking while performing a cognitive task) reveals fall risk that single-task assessments miss; delirium is an acute, reversible cause of both cognitive impairment and falls. VISION: corrected visual acuity, depth perception, contrast sensitivity, and peripheral vision all affect fall risk; multifocal lenses (bifocals, progressive lenses)...