Fast Tests for Predicting Fall Risk in Older Adults

February 6, 2023

Falls in older adults are a problem. A big problem. According to the latest estimates, 1 in 4 Americans over the age of 65 will fall this year because of their age alone. The likelihood increases to 1 in 3 when that person turns 80. When we start to add in other risk factors like medications, use of a cane or walker, or just a fear of falling it becomes more likely than not that the older adult we care for will fall. Our list doesn’t even consider the top predictor of falls for seniors: a previous fall. That’s right! A previous fall more than doubles the risk that our loved one will fall again.

“What can be done? Isn’t it just a fact of life that older adults fall? That’s how it’s always been.”

The saying, “an ounce of prevention is worth a pound of cure,” isn’t just a cute expression. When we know something bad is possible, we often take measures to prevent it from happening. We may go to the doctor for an annual checkup, lock the doors to our home, or save a little money “for a rainy day.” Preventing many falls is possible too if we know where to look and what to do.

We are passionate about preventing falls in the elderly and fall prevention for seniors.

In only 10 minutes, you can have a better and much more accurate idea of the risk for falls for the older adult for whom you care:

Walk Around the Home with Your “Risk-Colored Glasses”

As you look around the home, keep your eyes open for things like

  • Narrow walkways (like between a sofa and coffee table),
  • Throw rugs (especially on carpet, but any throw rug can present a hazard),
  • The pathway from bedroom to bathroom (looking at lighting and ease of access),
  • Thresholds between rooms or floor styles (a trip hazard for those dragging feet?),
  • Need to access different floors to the home
  • Ask the Big 6

We want to have an accurate idea of the 6 factors that independently increase fall risk:

  • Any falls in the last year?
  • Do you worry about falling?
  • Do you feel unsteady while standing or walking?
  • Do you use an assistive device to walk (cane, walker, etc.)?
  • Have you been hospitalized recently (past 3 mos)?
  • Do you use a psychoactive medication?

A “yes” answer to any of these is not cause to worry. It should only serve to clue you in to an area where more attention is needed.

The Safe Mobility “Tests”

I like 2 simple tests to tell me about strength (the body’s ability to help us stand) and balance (the body’s ability to keep us standing). When applying these tests, we should always be next to our client and ready to assist should balance be lost!

5-Times Sit to Stand Test

It’s exactly what it sounds like: You time how long it takes for a person to stand up and sit down from a chair. They may use their hands to assist if needed. The timer starts when you say “go” and stops when their bottom hits the chair for the 5th time.

A score of 12-15 seconds is expected performance while a score of 20 seconds or greater requires further investigation. A referral may be needed here.

Timed Up and Go (TUG) Test

Setting a chair at one end of a 9-foot walkway (there should be no obstacles in the way), the client is asked to stand, walk the 9 feet, return, and sit back in the chair. I often put a small object (usually my pen) on the floor at the 9-foot mark for them to walk around. The timer starts when you say “go” and stops when their bottom hits the chair.

Like the 5xSTS Test, a score of 12-15 seconds is expected performance while a score of 20 seconds or greater requires further investigation which may also require a referral. In these 3 simple steps, which should only take about 10 minutes, you can literally see into the future. Your observations can spot the potential for a fall which will lead you to take precautions in preventing those falls. In doing the very same assessments in the home (with the addition of physical therapy for people who had multiple risk factors or performed outside of expected range on the mobility tests) we have seen reductions in falls by more than 20% and reductions in hospitalizations by more than 40%.


  • If you’re concerned about falling, either for yourself or a loved one, there are things you can do. You don’t have to wait for the “other shoe to drop.”
  • Falls are often predictable and you can know your risk with a couple simple, safe, and quick tests
  • If you’re concerned about falling and don’t know where to start, hire a physical therapist experienced in working with older adults to lower your fall risk today. Start here (Get to Know YOUR Risk for Falls)

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