Are you worried about falling? Do the test!

For each activity, circle the score that matches how worried you are about falling.
If you use a walking aid, picture yourself doing the activity with the aid.
If you don’t do an activity (anymore), indicate how worried you would be if you did do the activity.
The total fall anxiety score is calculated by adding the points for each activity

Dressing or undressing	1	2	3
Taking a bath	1	2	3
Showering	1	2	3
Grocery shopping	1	2	3
Walking down the stairs	1	2	3
Taking a walk in the neighborhood	1	2	3
Reaching for something above head height when standing on a sturdy stepladder	1	2	3
Reaching for something above head height when standing on a chair	1	2	3
Attending social events (such as visiting friends or going to the card club)	1	2	3
Cleaning gutters	1	2	3

Add the points for each activity and note down the total score.

10 - 12	You are not very worried about falling and can still do many activities. This is positive news! Stay active and do as many activities independently as possible.
13 - 15	You are a little worried about falling, but it is not really affecting your behavior yet. Do as many activities independently as possible and ask for help from your son/daughter/neighbor or friend if needed. You could also try using a (walking) aid.
16 - 19	You are quite worried about falling so you have stopped doing certain activities. Talk to someone (such as your family or your doctor). A specific and customized exercise program or a guided conversation with peers could help to reduce your fear of falling.
20 - 30	You are very worried about falling and you are limited in your activities, which is lowering your quality of life. Talk to someone (such as your family or your doctor). Small adjustments in your behavior and environment can make a big difference. What’s more, a specific and customized exercise program or a guided conversation with peers could help to reduce your fear of falling. Work one step at a time.