• Marna Rayl Greenberg, Michael C Nguyen, Brian Stello, Arnold R Goldberg, Robert D Barraco, Bernadette G Porter, Anita Kurt, Stephen W Dusza, and Bryan G Kane.
• Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.
• J Emerg Med. 2015 Jan 1;48(1):108-114.e2.

BackgroundFalls in the elderly cause serious injury.ObjectiveWe aimed to determine subjects' comfort in discussing fall risk and home safety evaluations.MethodsThis prospective study surveyed a convenience sample of subjects (≥50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey-validated surveys measuring fall concern and functional decline. Other data-environmental living conditions, participant behaviors, fall frequency-were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression.ResultsParticipants (n = 416, 38% males, 62% females) had a mean age of 67.6 years; 35% were high fall risk. Previous year falls (p = 0.002), use of assistive device (p < 0.001), having at least one alcoholic drink/week (p = 0.043), and poor or fair perceived health status (p < 0.001) were associated with perceived fall risk. HF respondents were more willing than FP respondents to discuss falls (84.9% vs. 73.1%, p = 0.025). The difference was not significant between the HF and ED respondents (84.9% vs. 76.9, p = 0.11). HF subjects were more willing than FP to have a home safety inspection (68.9% vs. 45.9%, p < 0.001). The difference was not significant between the HF and ED respondents (68.9% vs 58.5, p = 0.09).ConclusionsPerceived and actual fall risks are highly associated. Most participants are willing to discuss their fall risk and a home safety evaluation. HF subjects were most willing to have these discussions; ED subjects were less willing than HF, but not significantly different from health fair participants. FP participants were significantly less willing to have these discussions than HF participants. This may suggest a meaningful opportunity for fall risk prevention in outpatient settings such as health fairs and the ED.Copyright © 2015 Elsevier Inc. All rights reserved.

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