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Assessment of Falls Risk in the Balance Disorders Laboratory

Department of Hearing and Speech Sciences, Division of Audiology, Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences

Falls in the elderly result in significant morbidity and mortality. They also may represent sentinel events suggesting a significant change in the health of an elderly patient. Aside from the human cost, additional costs associated with the surgical repair of hip and wrist fractures, the most common injuries resulting from falls, add expense to an already overburdened health care system. In the current report, a 10-factor falls risk assessment is described that we developed first for the Henry Ford Health System in Detroit and then for the Vanderbilt Bill Wilkerson Center in Nashville. The performance of the first 180 patients evaluated in this program also is described. Finally, a summary of the results of systematic reviews of the literature in the area of falls risk interventions is presented. In particular we were impressed by the proportion of patients with multiple sensory system impairments. While we were not surprised that 93% of these patients demonstrated somatosensory system impairments, we were surprised that 73% of these patients showed quantitative evidence of having undiagnosed peripheral and central vestibular system impairments. It is our feeling that the assessment of falls risk in the elderly falls directly within the scope of practice of audiology.