Question

Which of the following is the least likely direct cause of falls in the elderly?

• A. Balance disturbance
• B. Rheumatoid arthritis
• C. Muscle weakness
• D. Hearing impairment

Hint:

Three options directly impair posture/gait; one is only indirectly linked.

Answer 1

The Correct Option is D

Step 1: Frame the question.
Falls in the elderly are multifactorial. The task is to pick the factor that is the weakest direct contributor among the options.

Step 2: Review the strong, direct risk factors.
Balance disturbance (vestibular/proprioceptive/cerebellar dysfunction) is one of the strongest predictors of falls. Lower-limb muscle weakness (sarcopenia) directly impairs postural recovery and is a leading modifiable risk factor. Rheumatoid arthritis causes joint deformity, pain, reduced mobility and gait instability, so it too directly raises fall risk.

Step 3: Position hearing impairment.
Hearing loss is an associated risk marker rather than a direct mechanical cause of falling. Its link is indirect (reduced spatial/environmental awareness, shared inner-ear pathology). Compared with balance, weakness and arthritis, it is the least direct cause.

Key fact: Among these, hearing impairment is the least direct cause of falls; balance disturbance, muscle weakness and arthritis are direct, well-established risk factors.