Stratification of fall risk in older adults according to different mobility and postural balance tests

Introduction
Falls among older adults represent a major public health problem. Although fall risk stratification is a key component of prevention, its application in clinical practice remains challenging. Differences in assessment methods may affect the identification of individuals at low to moderate risk and influence the selection of appropriate interventions.

Methods
This descriptive study recruited older adults of both sexes. Sociodemographic data and health conditions were collected, and three key questions related to falls were applied. Participants were assessed for criteria associated with high fall risk according to the algorithm proposed by Montero-Odasso et al. (2022). Physical and functional assessments included habitual gait speed (HGS) and the Timed Up and Go (TUG) test. Postural balance was assessed using tandem and single-leg stance tests, with increased fall risk defined as tandem stance ≤ 18 seconds or single-leg stance < 11 seconds, according to Abreu et al. (2024). Ethics approval: CAAE: 62209916.5.0000.5440

Results
A total of 68 participants were evaluated, with a mean age of 72.0 ± 8.25 years; 64.7% were female According to the criteria proposed by Montero-Odasso et al. (2022), 35.4% of participants were classified as high risk. Based on HGS, 58.8% classified as low risk and 5.8% as moderate risk. Using the TUG, 57.4% were classified as low risk and 7.4% as moderate risk. When postural balance tests replaced mobility tests, 8.9% of participants were classified as low risk and 55.9% as moderate risk.

Conclusion
Mobility-based assessments yielded similar proportions of low and moderate fall risk, with a predominance of low-risk classification according to Montero-Odasso et al. (2022). In contrast, the use of balance tests substantially altered the stratification profile, increasing the proportion of older adults classified as moderate risk. These findings highlight the importance of integrating both mobility and balance assessments in fall risk stratification among older adults.