However, current AGS guidelines generally accept that screening for visual impairment followed by appropriate management should be part of the multifactorial assessment for falls, as visual impairment is known to greatly increase fall risk and several trials which include vision intervention showed positive overall results.
The script and algorithm were developed with the idea of conducting a simplified multifactorial assessment for fall risk factors [ 6] and tailoring interventions to the patient's needs.
The results of this review provide evidence for a third approach, having multiple components that target the population of interest rather than targeting individual risk factors, which may be potentially less resource intensive than multifactorial programmes as staff would not need to undertake in-depth, multifactorial assessment to establish individual risk factors.
Any patient over the age of 65 who falls should have a multifactorial assessment that includes assessment of cognition, continence, medication, mobility problems, postural instability, and visual impairment.
This study explored older people's exposure to, and perceptions of, multifactorial assessment and intervention programs such as a falls clinic.
Similarly, another meta-analysis of multifactorial assessment and intervention programmes to prevent falls and injuries among older adults reported a relative risk of 0.91 (95% confidence interval 0.82 1.02) [ 20].
18 The aim of this study was to evaluate the effectiveness of a multifactorial assessment and targeted intervention to reduce falls among the oldest-old community-dwelling persons, including those with cognitive impairment and comorbidities.
International and UK guidelines [ 9, 39, 44] give conflicting recommendations as to whether older people that have fallen or are at high risk of falling should receive multifactorial assessment and individually tailored interventions.
Currently, patients are diagnosed with COPD following a multifactorial assessment that includes clinical presentation, symptomatology, and risk factors in combination with the gold-standard of spirometry.
