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Falls Prevention Osteoporosis — SCE Rheumatology MCQ

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EasyMetabolic Bone DiseaseFalls Prevention OsteoporosisSCE Rheumatology

A 75-year-old woman with osteoporosis and previous vertebral fractures has started osteoporosis treatment. She reports two falls during the past year and lives independently. Which is the most appropriate approach to reducing her risk of further falls?

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Correct answer: D — Undertake comprehensive falls assessment and tailor interventions to the modifiable risks identified.

Two falls in the preceding year meet NICE criteria for comprehensive falls assessment and management. This should identify individual risk factors, including gait, balance and muscle strength, postural hypotension and other cardiovascular factors, medicines, vision, footwear and environmental hazards. Management is then tailored and may include progressive balance and strength exercise, structured medication adjustment, cataract referral and home-hazard intervention. Exercise or medication review alone may be useful but is insufficient when multiple risks may coexist. Walking aids and hip protectors should not be prescribed routinely without individual assessment. Vitamin D remains relevant to bone and muscle health and should be managed according to deficiency and public-health advice, but NICE finds insufficient evidence to prescribe it specifically as a falls-prevention intervention.

Reference: National Institute for Health and Care Excellence. Falls: assessment and prevention in older people and in people 50 and over at higher risk. NICE guideline NG249, recommendations 1.1.3, 1.2.2–1.2.3 and 1.3.1–1.3.10. 2025. https://www.nice.org.uk/guidance/ng249/chapter/Recommendations