1. I have fallen in the last 6 months. *

Yes

Why is this important?

People who have already fallen are likely to fall again.

2. I use or have been advised to use a cane or walker to get around safely. *

Yes

Why is this important?

Canes or walkers can reduce the chance of falling, but only when used correctly.

3. When walking, I sometimes feel unsteady. *

Yes

4. When walking at home, I hold on to furniture to steady myself. *

Why is this important?

Unsteadiness and needing support while walking are signs of poor balance.

5. I worry about falling. *

Yes

Why is this important?

People who worry about falling are at risk for a serious fall.

6. When standing up from a chair, I use my hands to help push myself up. *

Yes

7. I have some trouble stepping up onto a curb. *

Yes

Why is this important?

These are signs of leg-muscle weakness-a major reason for falling.

8. I often have to rush to the toilet. *

Yes

Why is this important?

Rushing to the bathroom, especially at night, increases your risk of falling.

9. I have lost some feeling in my feet. *

Yes

Why is this important?

Numbness in the feet can cause stumbles and falls.

10. I take medicine that sometimes makes me feel light-headed or more tired than usual. *

Yes

11. I take medicine to help me sleep or improve my mood. *

Yes

Why is this important?

Medication side effects can sometimes increase the risk of falls and fall-related injuries.

12. I often feel sad or depressed. *

Yes

Why is this important?

Symptoms of depression, such as not feeling well or feeling slowed down, are associated with falls.

13. Because I don't see well, I have difficulty avoiding hazards in my path, such as tree roots or electrical cords. *

Yes

Why is this important?

Poor vision is linked to falls and injuries.

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This quiz was developed using qualitative data taken from:

Rubenstein LZ, Vivrette R, Harker JO, Stevens JA, Kramer BJ. Validating an evidence-based, self rated fall risk questionnaire (FRQ) for older adults. J Safety Res 2011;42(6):493-499.