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Impact of Geriatric Falls Screening on Fall-Risk Detection among Older Adults in Nigeria

Abstract

Falls are an important public health concern among older adults in Nigeria and may result in fractures, head injuries, disability, loss of independence, hospitalization, reduced quality of life, and increased healthcare costs. Older adults may be particularly vulnerable to falls because of age-related changes in balance, muscle strength, vision, mobility, cognition, and coordination, as well as chronic diseases, medication use, environmental hazards, and other risk factors. Many fall-risk factors may remain unidentified until an actual fall occurs, making early identification essential for effective prevention. Geriatric falls screening provides an opportunity to systematically assess older adults for factors associated with falling through evaluation of balance, gait, mobility, muscle strength, vision, medication use, previous falls, functional ability, and environmental risks. Early identification of fall risk may allow healthcare providers, caregivers, and older adults to implement appropriate preventive measures, including exercise programmes, medication review, vision correction, assistive devices, environmental modification, and referral for further assessment. However, limited access to geriatric healthcare services, inadequate screening facilities, shortage of trained healthcare personnel, low awareness, financial barriers, transportation difficulties, and weak referral systems may limit the implementation of falls screening programmes in Nigeria. Against this background, this study investigates the impact of geriatric falls screening on fall-risk detection among older adults in Nigeria. The study will be anchored on the Health Belief Model, International Classification of Functioning, Disability and Health (ICF) Framework, and Health Systems Framework. The Health Belief Model explains how older adults' perceptions of their susceptibility to falls, perceived severity of fall-related consequences, perceived benefits of screening, perceived barriers, and cues to action may influence participation in falls screening. The ICF Framework provides a comprehensive approach to understanding functioning and disability by considering the interaction between health conditions, body functions, activities, participation, environmental factors, and personal factors. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective geriatric healthcare services. Collectively, these theoretical perspectives provide a suitable framework for explaining how geriatric falls screening may influence fall-risk detection among older adults in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adults aged 60 years and above residing in selected communities and accessing healthcare services in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, healthcare facilities, and eligible older adults. Geriatric falls screening will be measured using indicators such as availability of falls screening services, frequency of screening, assessment of previous falls, gait assessment, balance assessment, mobility assessment, muscle strength evaluation, vision assessment, medication review, functional assessment, environmental risk assessment, and availability of trained healthcare personnel. Fall-risk detection will be assessed using indicators such as identification of individuals at low, moderate, or high risk of falling, abnormal balance or gait findings, previous fall history, mobility limitations, medication-related risks, visual impairment, environmental hazards, functional limitations, and referrals for further assessment or preventive intervention. Data will be collected using structured questionnaires, validated fall-risk assessment tools, geriatric assessment records, healthcare facility records, screening registers, medication records, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, and fall-risk patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the impact of geriatric falls screening on fall-risk detection. Where appropriate, fall-risk detection before and after implementation of falls screening programmes may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that geriatric falls screening has a significant positive impact on fall-risk detection among older adults in Nigeria. Older adults who participate in regular falls screening are expected to have a higher likelihood of having previously unrecognized fall-risk factors identified than older adults without access to screening services. Systematic assessment of gait, balance, muscle strength, vision, medication use, previous falls, functional ability, and environmental hazards may facilitate early identification of individuals at increased risk of falling. Early detection may provide opportunities for targeted preventive interventions, including balance and strength exercises, medication review, vision assessment and correction, use of appropriate assistive devices, home and environmental modifications, and referral to physiotherapy or other relevant healthcare professionals. Geriatric falls screening may also improve awareness among older adults and caregivers regarding preventable fall-risk factors. Conversely, inadequate screening coverage, limited geriatric services, shortages of trained healthcare personnel, financial barriers, low awareness, and weak referral and follow-up systems may reduce the effectiveness of falls screening programmes. The study therefore expects accessible and well-organized geriatric falls screening to contribute significantly to improved detection of fall risk and prevention of falls among older adults in Nigeria. The study is expected to contribute to the literature on geriatric falls screening, fall-risk detection, older adult health, injury prevention, geriatric care, functional independence, rehabilitation, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, geriatric healthcare providers, physiotherapists, occupational therapists, community health workers, older adult health programmes, development partners, and policymakers regarding strategies for preventing falls among older adults. The study will also provide evidence-based recommendations for expanding geriatric falls screening services, integrating fall-risk assessment into routine primary and geriatric healthcare, strengthening training of healthcare workers, improving access to mobility and assistive devices, increasing awareness among older adults and caregivers, strengthening referral and follow-up systems, promoting exercise and balance programmes, and improving environmental safety to reduce fall-related injuries and promote healthy ageing among older adults across Nigeria.

Keywords: Geriatric falls screening, fall-risk detection, older adults, falls prevention, geriatric health, balance assessment, gait assessment, injury prevention, functional independence, rehabilitation, Nigeria, public health.