Authors (including presenting author) :
Tong MCJ, Lee WYA, Poon WYM
Affiliation :
Physiotherapy Department, Hong Kong Buddhist Hospital (HKBH)
Keyword 2: :
Stratification
Keyword 4: :
Physiotherapy
Introduction :
Falls are prevalent among elderly, leading to physical disability and functional dependence. There were no standardized structural tools for management planning. Recent world guidelines for falls in older adults introduced a standardized risk stratification system to categorize patients into low, intermediate, or high fall risk levels using simple resources, enabling targeted prevention and management.
Objectives :
This project is to implement standardized fall stratification system to review different fall profiles of patients in geriatric ward of HKBH for target interventions based on risk identified.
Methodology :
From 8 December 2025 to 12 Jan 2026, fall risk screening was conducted for patients admitted to one geriatric ward in HKBH by using standardized fall stratification system. Exclusions included non-communicable, premorbid chair-/bed-bounded patients. Using fall stratification system, screening started with three key questions: i)history of falls in past year, ii)feeling unsteady when standing/walking, iii)worry about falling. Negative responses to all indicated low-risk. Positive responses triggered fall severity assessment. High-risk was assigned for severe prior injury/high frailty level. Non-frail patients without fall history underwent gait/balance tests(4-meter gait speed and Timed Up-and-Go). Patients with impairments found were intermediate-risk. Other factors including social history, medical aspect and physical factors were also analyzed.
Result & Outcome :
Of 80 patients screened, 38 were included. Patients were stratified into high-risk(81.6%), intermediate-risk(5.3%) and low-risk(13.2%). For low-risk group, no fall history reported in past year and all of them managed to walk unaided independently premorbid. For the intermediate-risk group, muscle weakness was the risk factor identified. For high-risk group, 64.5% was independent in walking premorbid. Past medical history including hypertension(87.1%), diabetes(58.1%), heart disease(58.1%) was common. 61.3% required to take cardiovascular medication. 54.8% reported fallen in past year. 93.5% reported felt unsteady during standing or walking and 74.2% reported worries about falling. The common physical fall risk factors identified were gait(90.3%), balance(83.9%) and muscle strength(74.2%). Education on fall prevention, drug and disease management was conducted to all patients. Tailored interventions included physical maintenance to low-risk group; strengthening exercise emphasized to intermediate-risk group; targeted exercises on balance/gait training and muscle strengthening to high-risk group. This pilot offered a preview on different fall profiles of patients in a geriatric ward. Studies in larger scale of patients would be meaningful. Implementing standardized fall risk stratification can offer guidance on interventions and planning in fall prevention.
