The APTA Geriatrics Balance and Falls Special Interest Group provides a monthly challenge to members. The February 2020 challenge written by Stephanie Bond, PT, DPT and Haim Nesser, PT, DPT addresses delirium, depression, dementia, and the risk of falls. A few highlights from this document include:

  • A study performed in 2017 found that only 32.7% of physical therapist participants were screened for cognition as part of their fall risk assessment.
  • At the 2019 Gerontological Society of America meeting, the Center for Disease Control encouraged adding cognitive screening to assess fall risk.
  • Identification of the signs and symptoms of delirium, depression, and dementia can help guide referrals to other health care providers to address the needs of the clients.
  • Recommendations for assessment tools include the Confusion Assessment Method (CAM) or the Richmond Agitation-Sedation Scale (RASS) for delirium, and the Geriatric Depression Scale for depression.  Cognitive assessments include the Mini-Cog and the Saint Louis University Mental Status Examination (SLUMS).  For those individuals with a progressive dementia diagnosis, the Global Deterioration Scale (GDS) can be the guide for the staging of the disease.

Remember that treatment for individuals who are dealing with delirium, depression, or dementia present additional challenges for clinicians. Early identification of these conditions can facilitate optimal outcomes and provide a foundation for a comprehensive fall prevention program.