FRAT-up
Fall Risk Assessment Tool
Current risk of the subject: Unknown
Unknown
Unknown
Unknown
Unknown
Health profile of the subject:
| Fear of falling (Deshpande)? |
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| Does the subject suffer Parkinson? |
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| Does the subject suffer rheumatic disease? |
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| Dizziness or unsteadiness last year? |
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| Does the subject use a walking aid? |
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| Does the subject use antiepileptics? |
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| Does the subject use antihypertensives? |
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| Urinary incontinence last year? |
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| Does the subject suffer any pain? |
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| Is the subject female? |
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| Does the subject use sedatives? |
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| History of previous falls? |
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| Does the subject live alone? |
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| Diabetes blood glucose 126? |
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| History of previous strokes? |
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| Number of drugs used by the subject: |
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| Contrast sensitivity?: |
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| Age: |
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| CESD: |
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| Revised Walking Subscore: |
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| How does the subject feel: |
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| Visual stereognosis: |
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| physical activity level: |
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| Hearing impairment?: |
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| MMSE score: |
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| Number of ADL disabilities (0-6): |
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| Subject's number of IADL: |
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| Visual acuity (3 meter): |
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