ABSTRACT. Background: Thirty percent of people aged 65 years or older fall at least once a year, and about a quarter seek medical attention. Existing falls risk profiles are too complex for daily use. We describe a falls decision tree consisting of three simple questions that provides a quick indication of the risk of recurrent falls in older people who have recently fallen down Methods: We investigated simple, easy to measure predictors of repeated falls in 408 community-dwelling older people (65+ years) who had consulted a GP or gone to an accident and emergency (A&E) department after falling down. These predictors were then used to develop a falls decision tree, to indicate when a new fall can be expected. The decision tree was validated in a second sample of patients. Results: Three predictors, namely, falls history, fear of falling, and use of a walking aid, in combination provided an adequate indication of the risk of a new fall. The risk of a new fall was 9% if none of the predictors was present and 42% if all three predictors were present. If high falls risk was defined as a higher than 30% risk of new falls, then 80% of the participants in the development sample and 70% of the participants in the validation sample were correctly classified as having a high falls risk. Conclusion: The falls decision tree is a simple tool for use in GP surgeries or in A&E departments to assess the risk of a new fall in older individuals who have recently fallen down.
