The fall-risk screening instrument ("Sturz-Risiko-Check" questionnaire) was useful and valid to predict risk of falling and functional decline in independently living senior citizens transitioning to frailty. This screening will be part of a prevention approach in the City of Hamburg to offer primary and secondary prevention interventions adapted to special target groups of community- dwelling elder people (robust in contrast to frail elderly). The implementation should be accompanied by training sessions for physicians in the primary care sector and health improvement programmes for elder citizens.

The results provide evidence indicating potential for improving health-promoting lifestyles in parts of the older population by evaluating and strengthening older persons' competencies and by considering their concerns seriously. These results provide valuable information for future plans in the public-health sector in the city of Hamburg where particular health-promoting actions for elderly persons will be considered.

Mobility is one of the most important factors for well-being and autonomy in old age. Impairments in mobility, falls and fear of falling are, therefore, of prognostic value. Falls generally result from an interaction of multiple risk factors. However, older people are often not aware of the risks of falling. They neither recognize risk factors nor report these factors to their physicians. The aim of this study was to develop and to test a self-reported multidimensional screening instrument to evaluate risk factors of falling in community-dwelling older people. Therefore, we identified multiple risk factors of falls based on a systematic literature review and then developed a new questionnaire - the Senior Citizen Risk of Falling Check. Risk factors, i.e. cognitive disorders, that are closely associated with the demand of nursing care were not covered in this relatively healthy target group. We pretested this instrument and adapted it before its use in a pilot test in residents of a sheltered housing complex in Hamburg. A group of 117 residents (average age 82.9 years, range 68.2-98.2 years, 83.8% women), all without care needs (assessed by the German health and care insurance system) returned the Senior Citizen Risk of Falling Check. Within 2 weeks all 117 participants were interviewed by telephone to analyze the test-retest reliability of the instrument (Cohen's kappa). We administered 13 questions on visual and hearing deficits, neurological impairment, depressive mood, medication use, muscle weakness, gait and balance deficits, nutrition, and history of falls. On average, 6 risk factors were reported (range 0-12). Reductions in gait speed (64.1%) was most frequently mentioned. Of the participants, 30.8% fell at least once during the last year and 22.2% of these falls resulted in injuries (fractures, hematomas, laceration, pain). Cohen's kappa was good (2/13 questions) to excellent (10/13 questions) with one exception (balance question kappa=0.20). The study results confirm good test-retest reliability of the fall risk screening Senior Citizen Risk of Falling Check. At the moment we are working on the validation of this questionnaire to provide it to senior citizens throughout Hamburg in cooperation with the City of Hamburg.