Assessment of Falls Risk in the Balance Disorders Laboratory 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 ... Article
Article  |   November 01, 2009
Assessment of Falls Risk in the Balance Disorders Laboratory
Author Affiliations & Notes
  • Gary P. Jacobson
    Department of Hearing and Speech Sciences, Division of Audiology, Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences
Article Information
Balance & Balance Disorders / Special Populations / Older Adults & Aging / Articles
Article   |   November 01, 2009
Assessment of Falls Risk in the Balance Disorders Laboratory
SIG 6 Perspectives on Hearing and Hearing Disorders: Research and Diagnostics, November 2009, Vol. 13, 54-59. doi:10.1044/hhd13.2.54
SIG 6 Perspectives on Hearing and Hearing Disorders: Research and Diagnostics, November 2009, Vol. 13, 54-59. doi:10.1044/hhd13.2.54
Abstract

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.

Acknowledgement
The author wishes to acknowledge his colleagues Devin L. McCaslin, PhD, Sarah L. Grantham, AuD, and Erin Piker, AuD, who work in the Vanderbilt Balance Disorders Laboratory and Falls Risk Assessment Clinic and have, and continue to, assess patients in the Falls Risk Assessment Clinic.
Data presented in this report have been reported previously in Jacobson, G. P., McCaslin, D. L., Grantham, S. L., & Piker, E. G. (2008). Significant vestibular system impairment is common in a cohort of elderly patients referred for assessment of falls risk. Journal of the American Academy of Audiology, 19, 799-807.
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