Grip strength (dynamometer)

• What it measures: Muscle strength reserve
• Why it matters: Strong predictor of frailty and mortality
• What this may help prevent: Falls, disability, hospital admissions, early need for rest home care

Standing balance (4-stage test)

• What it measures: Postural stability
• Why it matters: Balance decline precedes falls
• What this may help prevent: Falls, low impact (osteoporotic) fractures, emergency presentations, loss of confidence

Vitamin D (blood)

• What it measures: Bone and neuromuscular function
• Why it matters: Deficiency increases weakness and falls
• What this may help prevent: Fractures, falls, hospital admissions

Falls history (past 12 months)

• What it measures: Falls frequency and circumstances
• Why it matters: A previous fall strongly predicts future falls and injury
• What this may help prevent: Recurrent falls, fractures, hospital admissions

Chair rise test (standing without hands)

• What it measures: Functional lower limb strength
• Why it matters: Difficulty rising is linked to higher fall, fracture and frailty risk
• What this may help prevent: Mobility loss, increasing dependence, early residential care

Osteoporosis risk profile (risk factors and history)

• What it measures: Clinical fracture risk (e.g., prior fracture, steroid exposure, family history)
• Why it matters: Hip and spine fractures are major drivers of disability in later life
• What this may help prevent: Fragility fractures, long-term disability, residential care entry

Vitamin D (blood test)

• What it measures: Bone and muscle support
• Why it matters: Deficiency increases falls and fracture risk
• What this may help prevent: Fragility fractures, recurrent falls

Serum calcium (blood test)

• What it measures: Calcium balance
• Why it matters: Abnormal levels may signal metabolic contributors to bone weakness
• What this may help prevent: Bone weakness, fracture risk

Mini-Addenbrooke’s Cognitive Examination (Mini-ACE) score

• What it measures: Cognitive performance across memory, attention, fluency and visuospatial skills
• Why it matters: Early cognitive changes may impact independence and daily function
• What this may help prevent: Medication errors, unsafe driving, financial vulnerability, avoidable hospital admissions and delirium during acute illness or hospital admission

Functional cognition questions (impact on hobbies, daily tasks, family feedback)

• What it measures: Real-world cognition and day-to-day functioning
• Why it matters: Functional decline often appears before formal diagnosis
• What this may help prevent: Safety risks at home, financial vulnerability

Vitamin B12 (blood test)

• What it measures: Nerve and brain health
• Why it matters: Low B12 can mimic cognitive decline and cause neuropathy
• What this may help prevent: Reversible confusion, falls from neuropathy

Thyroid stimulating hormone (TSH) (blood test)

• What it measures: Thyroid balance affecting energy and cognition
• Why it matters: Thyroid dysfunction can present as memory issues
• What this may help prevent: Treatable cognitive symptoms

Glycated haemoglobin (HbA1c) (blood test)

• What it measures: Long-term blood sugar exposure
• Why it matters: Higher levels increase cardiovascular and cerebrovascular risk
• What this may help prevent: Stroke and vascular dementia

Social connection frequency (contact pattern)

• What it measures: How often a person connects with others
• Why it matters: Isolation is linked to poorer health outcomes and faster decline
• What this may help prevent: Depression, accelerated cognitive decline, avoidable admissions

Loneliness Indicator

• What it measures: How lonely a person feels regardless of contacts
• Why it matters: Loneliness is a strong predictor of decline
• What this may help prevent: Depression, functional decline, early residential care

Purpose and Quality of Life Indicator

• What it measures: Overall wellbeing trajectory
• Why it matters: Purpose and wellbeing correlate with resilience and health behaviours
• What this may help prevent: Loss of motivation, reduced activity, decline

Sleep quality

• What it measures: Difficulty falling or staying asleep
• Why it matters: Poor sleep and sedative medications increase falls risk, mood symptoms and cognitive strain
• What this may help prevent: Falls, hospital admissions, daytime impairment

Daytime sleepiness

• What it measures: Daytime alertness and fatigue
• Why it matters: Daytime sleepiness affects driving and safety
• What this may help prevent: Accidents, falls, reduced function

Nutritional Assessment

• What it measures: Malnutrition risk
• Why it matters: Malnutrition increases frailty, infection risk and poor recovery
• What this may help prevent: Hospital admissions, infections, early residential care

Body mass index (BMI)

• What it measures: Body size relative to height
• Why it matters: Both low BMI and high BMI increase health risk in ageing
• What this may help prevent: Frailty, diabetes, heart disease

Recent weight loss / reduced intake

• What it measures: Catabolic risk and appetite change
• Why it matters: Unintentional weight loss can signal illness and increases frailty risk
• What this may help prevent: Frailty progression, hospital admissions

Serum albumin (blood test)

• What it measures: Protein reserve and illness burden and liver synthetic function
• Why it matters: Low levels predict poorer recovery and resilience
• What this may help prevent: Hospitalisation risk, delayed recovery

Iron studies (blood test: ferritin, transferrin saturation and iron)

• What it measures: Iron stores and availability
• Why it matters: Low iron status contributes to fatigue, weakness and reduced exercise tolerance
• What this may help prevent: Falls risk, functional decline

Folate (blood test)

• What it measures: Nutrient supporting red blood cells and brain
• Why it matters: Low folate can contribute to fatigue and cognitive symptoms
• What this may help prevent: Functional decline

Vitamin B12 (blood test)

• What it measures: Nerve and brain health
• Why it matters: Deficiency can cause neuropathy and cognitive symptoms
• What this may help prevent: Falls (via neuropathy), cognitive impairment

Hearing difficulty

• What it measures: Hearing function in daily life
• Why it matters: Hearing loss is linked to isolation and cognitive strain
• What this may help prevent: Depression, cognitive decline, safety issues

Snellen visual acuity test

• What it measures: Distance vision clarity
• Why it matters: Vision loss increases falls and driving risk
• What this may help prevent: Falls, driving accidents

Functional vision questions

• What it measures: Everyday vision capability
• Why it matters: Functional impairment predicts medication and safety errors
• What this may help prevent: Medication errors, falls

Oral health status (pain, dentures fit, last dental visit)

• What it measures: Oral comfort, chewing and dental care access
• Why it matters: Oral health affects nutrition and infection risk
• What this may help prevent: Weight loss, infections, poor nutrition

Polypharmacy count (regular medicines)

• What it measures: Medication burden
• Why it matters: Higher medication burden increases side effects and interactions
• What this may help prevent: Falls, delirium, avoidable hospital admissions

High-risk medication exposure (e.g., sedatives, strong pain medicines)

• What it measures: Medication-related harm risk
• Why it matters: Certain medicines increase falls, confusion and bleeding risk
• What this may help prevent: Falls, delirium, admissions to hospital and residential care

Adherence and medication system reliability

• What it measures: Ability to take medicines correctly
• Why it matters: Missed doses or double dosing can cause harm or deterioration
• What this may help prevent: Avoidable admissions, treatment failure

Glomerular Filtration Rate (GFR) (blood test)

• What it measures: Kidney filtration for safe dosing
• Why it matters: Kidney function changes with age and affects medication safety
• What this may help prevent: Drug toxicity, hospital admissions

Creatinine (blood test)

• What it measures: Kidney function marker used to calculate eGFR
• Why it matters: Supports safe prescribing
• What this may help prevent: Drug toxicity

Liver function tests (ALT, AST, GGT, Albumin) (blood test)

• What it measures: Liver enzymes and synthetic function
• Why it matters: Liver function influences medication metabolism and overall health
• What this may help prevent: Medication-related harm, broader health risk

Blood pressure (lying and standing)

• What it measures: Blood pressure control and postural drop
• Why it matters: Major driver of stroke and dizziness-related falls
• What this may help prevent: Stroke, fainting (syncope), hospital admissions

Pulse rate and rhythm check

• What it measures: Heart rate and rhythm regularity
• Why it matters: Irregular rhythm can indicate atrial fibrillation (AF)
• What this may help prevent: Stroke, heart failure exacerbations

Glycated haemoglobin (HbA1c) (blood test)

• What it measures: Long-term glucose exposure
• Why it matters: Higher levels accelerate vascular ageing
• What this may help prevent: Diabetes complications, vascular events

Total cholesterol (blood test)

• What it measures: Overall cholesterol level
• Why it matters: High levels contribute to plaque build-up
• What this may help prevent: Heart attack, stroke

Low-density lipoprotein cholesterol (LDL) (blood test)

• What it measures: “Bad” cholesterol
• Why it matters: Key driver of atherosclerosis
• What this may help prevent: Heart attack, stroke

High-density lipoprotein cholesterol (HDL) (blood test)

• What it measures: “Good” cholesterol
• Why it matters: Low levels associated with higher risk
• What this may help prevent: Vascular events

Triglycerides (blood test)

• What it measures: Blood fat linked to insulin resistance
• Why it matters: Elevated levels increase cardiometabolic risk
• What this may help prevent: Vascular events

Bowel function pattern (frequency, stool form, straining)

• What it measures: Constipation/diarrhoea pattern and severity
• Why it matters: Bowel issues impact comfort, appetite, sleep and function, urinary function.
• What this may help prevent: Delirium from constipation, avoidable hospital admissions, bladder dysfunction

Blood in stool or change in bowel habit (red flags)

• What it measures: Warning symptoms for bowel disease
• Why it matters: Early identification improves outcomes
• What this may help prevent: Advanced bowel disease, delayed diagnosis

Faecal incontinence frequency and impact

• What it measures: Bowel control and quality-of-life impact
• Why it matters: Major driver of social withdrawal and care needs
• What this may help prevent: Loss of independence, early residential care

Urinary symptoms (women: leakage frequency/type and bother)

• What it measures: Bladder control and symptom impact
• Why it matters: Incontinence increases falls risk and social withdrawal
• What this may help prevent: Falls, sleep disruption, depression

Urinary symptoms (men: lower urinary tract symptoms and nocturia)

• What it measures: Flow and night-time urination burden
• Why it matters: Nocturia contributes to falls and daytime fatigue
• What this may help prevent: Falls, functional decline related to poor sleep

Pad use (24 hours)

• What it measures: Practical severity marker
• Why it matters: Helps quantify impact and need for support
• What this may help prevent: Skin irritation, social withdrawal

Pain severity and impact assessment

• What it measures: Pain burden and functional limitation
• Why it matters: Persistent pain drives inactivity, frailty and mood decline
• What this may help prevent: Mobility loss, falls, avoidable admissions

Morning stiffness duration and pattern

• What it measures: Inflammatory vs mechanical pain signals
• Why it matters: Inflammatory arthritis needs early identification to prevent joint damage
• What this may help prevent: Progressive joint damage, disability

Driving exposure and pattern (how often, where, day/night)

• What it measures: Driving frequency and complexity
• Why it matters: Higher exposure increases risk if function declines
• What this may help prevent: Accidents, injury, loss of licence crisis

Driving concerns (self and family) and near-misses

• What it measures: Perceived safety and recent warning signs
• Why it matters: Concerns often precede incidents
• What this may help prevent: Accidents, injury-related admissions

Home safety

• What it measures: Environmental fall and safety hazards
• Why it matters: Home hazards are a common, modifiable contributor to falls
• What this may help prevent: Falls, fractures, hospital admissions