The Prevention and Management of Falls in the Community: A Framework for Action for Scotland 2014/2015

The Framework builds on the model presented in the Up and About resource, and focuses on falls prevention and management and fracture prevention for older people living in the community. The Framework is underpinned by evidence from research and draws on knowledge and experience gained by the falls prevention community in Scotland over the last four years.

Appendix 2: Further guidance on Level 2 assessment

Recommendations for Level 2 Assessment (Multifactorial screen)

Assessment component

Additional information:

Gait and balance, mobility and muscle strength


A simple test such as the Timed Up and Go or the Up and Go will provide the opportunity to observe difficulties with standing from sitting, balance, walking, turning and sitting down.

Fear of falling


If you would like to use an assessment tool as part of the screen, the Falls Efficacy Scale- International is validated.

Cognitive impairment

Abbreviated Mental Test is commonly used.

Cardiovascular symptoms


  • Enquire about existing heart problems including arrhythmias, valve disease, palpitations
  • Ask about any blackouts, or light-headedness when standing from lying/sitting
  • Consider checking lying to standing BP if the assessor is trained, competent and has suitable equipment

Neurological symptoms


  • Identify problems with co-ordination and balance while screening gait and balance (see above)
  • Enquire about loss of sensation.



  • polypharmacy
  • types of medications
  • compliance with medication
  • reason for non-compliance.

Agree the screening/trigger questions locally with the service or professional the assessor will be referring on to, such as the GP, pharmacist or falls clinic etc.

Nutritional status


weight loss and chewing problems.


Email: Julie Townsend

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