Falls Profile of Older Adults Attending a Community Specialist Team for Comprehensive Geriatric Assessment

Background The aim of this study was to evaluate the falls risk stratification, assessment and management of older adults who receive Comprehensive Geriatric Assessment (CGA). Methods A retrospective evaluation was undertaken of all patients ≥65 years who attended a Community Specialist Team over a 7-month period. Falls risk stratification and Multifactorial Falls Risk Assessment (MFRA) were undertaken as part of CGA. Data was analysed using descriptive statistics and binary logistic regression. Results Ninety-six patients attended during the study period, 37 male, 59 female, mean age: 80 years (SD=7), median Clinical Frailty Scale score: 5 (mild frailty), Barthel score: 17/20 (low dependency). Forty-four percent (n=42) were referred for CGA because of falling. Opportunistic screening identified 97% (n=93) had falls risks, 86% (n=83) were high risk and 66% (n=63) reported falling in the past year. Balance and gait impairment was an independent predictor of falls (OR=3.167, CI=1.157-8.668, p<0.025). Other risk factors were musculoskeletal disorder (68% n=65), cognitive impairment (66% n=63), Falls-Risk-Increasing-Drgs (62% n=59), probable sarcopenia (40% n=38) and Orthostatic Hypotension (30% n=28). Median number of falls-specific interventions required was 4 (range 0-9). Most frequent interventions were Physiotherapy (51% n=49), medication changes (47% n=45), Dietetics (42% n=40), Occupational Therapy (38% n=36), Pharmacy (35% n=33), Memory Clinic (35% n=34) and Cardiology (13% n=12). Conclusion Older adults attending for CGA are at high risk for falls. MFRA is an essential component of CGA. This evaluation will guide multi-domain service delivery to address the key risk factors.