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Falls prevention — USMLE Step 3 MCQ

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HardAmbulatory Medicine / Primary CareFalls preventionUSMLE Step 3

A 77-year-old community-dwelling woman reports two falls in the past year. She has no syncope, focal deficit, or sedative use, but gait speed and Timed Up and Go testing are abnormal. Which intervention has the clearest USPSTF-supported net benefit?

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Correct answer: E — Refer for supervised multicomponent exercise emphasizing progressive balance and strength training

The best answer is “Refer for supervised multicomponent exercise emphasizing progressive balance and strength training”. For community-dwelling adults 65 or older at increased fall risk, structured exercise—especially gait, balance, functional, and strength training—has the most consistent benefit. Multifactorial interventions may be individualized, but immobilization, sedatives, and routine neuroimaging can cause harm or lack benefit.

Reference: USPSTF: Falls Prevention in Community-Dwelling Older Adults: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-community-dwelling-older-adults-interventions