Year of Award


Document Type


Degree Type

Doctor of Philosophy (PhD)

Degree Name

Individualized Interdisciplinary Doctoral Program

Other Degree Name/Area of Focus

Public Health, Geriatrics, Physical Therapy

Department or School/College

Interdisciplinary Studies Program

Committee Chair

Craig Molgaard

Commitee Members

Duncan Campbell, Steven Fehrer, Gayle Hudgins, Ann Williams


fall prevention, fall risk assessment, fall risk screening, community-dwelling, older adults


University of Montana


Background: Unintentional falls are an increasing public health problem as incidence of falls rises and the population ages. The Centers for Disease Control and Prevention reports that 1 in 3 adults aged 65 years and older will experience a fall this year; 20% to 30% of those who fall will sustain a moderate to severe injury. Physical therapists (PTs) and other primary care practitioners (PCPs) caring for older adults are usually engaged with these patients after the first injury fall and may have little opportunity to abate fall risk before the injuries occur.

Purpose: This manuscript describes the content selection, development and validation of a simple-to-administer, multifactorial Fall Risk Assessment & Screening Tool (FRAST). The FRAST is designed specifically for use in primary care settings by minimally-trained staff to identify those older adults with heightened fall risk requiring PCP intervention. The FRAST incorporates previously validated measures within a new multifactorial tool and includes targeted recommendations for intervention.

Methods: Development of the multifactorial FRAST used a 5-part process: identification of significant fall risk factors, review of best evidence, selection of items, creation of the scoring grid, and development of a recommended action plan. The FRAST was then validated via data collection across Montana in 2010 and included 99 subjects fitting specified inclusion/exclusion criteria: aged 65+, community-dwelling, independent ambulators (with or without assistive devices).

Results: FRAST has been developed and validated to assess fall risk in the target population. Many fall risk factors have been considered and 15 items selected for inclusion. FRAST includes four previously validated measures to assess balance, depression, falls efficacy, and home safety.

Conclusion: Fall risk for community-dwelling older adults is an urgent, multifactorial, public health problem. Providing PCPs with a very simple screening tool is imperative. FRAST was created and validated to allow for safe, quick, and low-cost fall risk screening by minimally-trained office staff with interpretation and follow-up provided by the PCP.



© Copyright 2011 Mindy Oxman Renfro