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Multifactorial Assessment

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Information for Adults

Assess All the Factors

A multifactorial assessment can identify the factors that put an adult at risk of falling and assist in identifying the interventions to reduce falls. Research has found that many health care providers fail to identify and evaluate adults at risk of falling in their clinical practices. Wenger and colleagues, found that only 34% of older patients receive any fall evaluation.

An assessment should be performed by a professional with appropriate skills and training (e.g. physician, nurse practioner, physical therapist, occupational therapist, or pharmacist).

Consider these factors in your assessment

History of Falls

Activity performed/setting at the time of the fall
Frequency of falls
Symptoms at the time of the fall
Previous injuries and consequences

Medication Review

Review of prescribed and over-the-counter medications

Visual Acuity Testing

Gait and Balance Assessment

Examination of gait, balance and lower extremity joint function

Functional Assessment

Limitations of activities of daily living
Limitations of instrumental activities of daily living

Physical Examination

Examination of basic neurological function, including mental status, muscle strength, lower extremity peripheral nerves, proprioception, reflexes, test of cortical, extrapyramidal, and cerebellar function
Assessment of basic cardiovascular status including heart rate and rhythm and orthostatic blood pressure 
Examination of the feet 

Environmental Assessment

Laboratory Testing

Choice of laboratory tests should be driven by the adult's history of falls and physical exam elements.

Fall risk evaluation and interventions for adults may be reimbursable.