BackgroundEarly in the development of geriatric medicine, falls were identified as a “geriatric giant”, a nonspecific indicator of functional decompensation. This led to the notion of “falls prevention services”, and the concept that identification of those patients at high risk of falls is essential to approach this group of elderly people. ObjectiveThis work was carried out aiming to develop a model that predicts falls risk for both in- as well as outpatients using clinical variables that are easily assessed in clinical practice. Study DesignA case-control study to determine the risk factors and the prediction rule of falls risk among older people. MethodsThree hundred and seventy-three outpatients and 186 inpatients, with a minimum age of 65 years, were assessed for falls risk factors. The clinical characteristics with independent predictive value for the development of falls were selected using logistic regression analysis. The diagnostic performance of the prediction rule was evaluated using the area under the curve. Cross-validation controlled for over fitting of the data (internal validation) was also carried out. ResultsThe prediction rule consisted of five clinical variables: history of falls in the last 12 months, slowing of the walking speed/change in gait, history of loss of balance in the last 12 months, and impaired sight and weak hand grip. The prediction score ranged from 0 to 6.5, and corresponded to the percent chance of sustaining a fall. For several cutoff values, the positive and negative predictive values were determined. The area under the curve values for the prediction rule was 0.89. ConclusionIn elderly people, the risk of sustaining a fall can be predicted, thereby allowing individualized decisions regarding the patient’s management. Falls risk assessment score is a new self-reported tool that can be used in standard clinical practice by all health care professionals both in the outpatient and the acute hospital inpatient settings. Assessing for the falls risk would help to minimize the negative impact of falling on the patient’s physical, psychological, and social functional abilities.