A fall can change an older adult’s life in a moment: a broken hip, a head injury, or simply a new fear of going out. The encouraging part is that falls are not an inevitable part of aging. Many of the causes can be found and fixed, and the exercises that prevent falls are well studied.

How common falls are

The CDC reports that more than one out of four people 65 and older falls each year, but fewer than half tell their doctor. Falling once doubles the chance of falling again. Each year older adults have about 4.5 million emergency department visits for falls, and falls are the most common cause of traumatic brain injury in this age group.

The CDC also notes that many people who fall, even without injury, become afraid of falling and cut back on activity. Less activity leads to weakness, which raises the risk of the next fall.

What raises the risk

The CDC lists risk factors that can often be changed:

  • Lower body weakness
  • Vitamin D deficiency
  • Difficulty with walking and balance
  • Medicines such as tranquilizers, sedatives and antidepressants, and even some over-the-counter medicines
  • Vision problems
  • Foot pain or poor footwear
  • Home hazards such as broken or uneven steps, throw rugs and clutter

Most falls come from a combination of these, and the more risk factors a person has, the higher the chance of falling. That is also good news: addressing even two or three of them can make a real difference.

Exercise that prevents falls

The US Preventive Services Task Force recommends exercise interventions to prevent falls in adults 65 and older who live in the community and are at increased risk. The CDC’s activity guidelines for older adults include activities that improve balance every week, alongside aerobic and strength work.

  • Strength. Leg and hip strength is the foundation. Rising from a chair without using your hands is a simple exercise and a useful test. See strength training after 50.
  • Balance practice. Standing on one foot near a counter, heel-to-toe walking and similar exercises, done safely and progressed slowly.
  • Tai chi. NCCIH notes that tai chi may improve balance and help prevent falls in older adults.
  • Physical therapy, when there is a specific problem such as a recent injury, joint replacement or dizziness.

What your doctor can check

The task force also says clinicians can individualize the decision to offer multifactorial interventions, meaning an assessment of the several things that raise one person’s risk. The CDC’s STEADI program gives clinicians a framework for that. In practice, a visit focused on falls may include:

  • A medicine review, looking for drugs that cause drowsiness, dizziness or a drop in blood pressure on standing. See why a full medication review matters.
  • Blood pressure lying and standing, to catch drops that cause lightheadedness.
  • Vision and hearing, and whether glasses or hearing aids are up to date.
  • Feet and footwear.
  • A quick look at gait, strength and balance.
  • Bone health, because the same fall is far more dangerous with thin bones. See bone density screening.

Vitamin D deficiency is on the CDC’s list of fall risk factors, and a simple blood test can check your level. The CDC also offers a one-page chair rise exercise and other STEADI materials for older adults who want to start at home. If you have fallen in the past year, or feel unsteady, say so at your next visit, even if you were not hurt.

Making the home safer

The National Institute on Aging lists exercising, managing medicines, having your vision checked and making your home safer as steps that prevent falls. Good lighting, grab bars in the bathroom, railings on both sides of stairs, removing throw rugs and keeping a light by the bed all help. NIA also encourages people not to let a fear of falling keep them from staying active, since activity itself helps prevent falls.

If someone you love has fallen

The CDC advises that an older person who falls and hits their head should see a doctor right away, especially if they take a blood thinner. For families, a fall is also a good moment to look at medicines, home setup and whether a parent needs more support. Our page for families arranging care explains how Legacy Medical works with adult children, with the patient’s written permission.

Members at Legacy Medical are seen the same or next business day, so a fall or a near miss can be looked at promptly rather than weeks later. To meet Dr. Shtern, book a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.