The Centers for Disease Control and Prevention has developed a practical algorithmic approach for identifying and managing older adults at risk of falls. The Stopping Elderly Accidents, Deaths & Injuries (STEADI) protocol has been shown to be teachable to health science students and faculty (Gerontol Geriatr Educ. 2019 Jan-Mar;40(1):105-120), and useful for community based fall risk screening (J Geriatr Phys Ther. 2019 Mar 15) to help target a sub-population that may be at a higher risk than other older adults.
The STEADI fall risk screening and prevention strategies among older adults in the primary care setting reduced fall-related hospitalizations in a large study in upstate New York (Gerontologist. 2019 Nov 16;59(6):1182-1191). This study has several key limitations: it was not randomized, results varied from clinic to clinic, fall prevention recommendations were inconsistent and patient engagement in them were not thoroughly documented, and finally data was only collected from one healthcare system (that is if falls in this patient population occurred causing hospital visits in a different healthcare system, that data was not captured).
Overall, STEADI recommendations are probably the best set of recommendations for primary care doctors but their efficacy is still questionable. Unfortunately very little is currently taught in the US medical school or medical residency curriculum for prevention of falls in older adults, and STEADI is the first step in the right direction to help physicians learn about fall prevention.
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