What causes falls in older adults? How can falls and fractures be prevented? Discover the key steps to maintain health and safety for older adults.

Understanding the Risks: Causes of Falls in Older Adults

Falls and fractures are a serious concern for older adults, with more than one in four people aged 65 and older experiencing a fall each year. Several factors can contribute to the increased risk of falls in this population:

• Declining eyesight, hearing, and reflexes due to aging
• Certain health conditions such as diabetes, heart disease, or neurological problems that affect balance and mobility
• Conditions that cause urgency to use the bathroom, like incontinence, leading to rushed movements
• Cognitive impairment or dementia, which can increase the risk of falls
• Age-related muscle loss (sarcopenia), balance issues, and postural hypotension (sudden drop in blood pressure when standing up)
• Foot problems and unsafe footwear, such as backless shoes or high heels
• Side effects from medications, especially when taking multiple drugs
• Environmental hazards in the home or community that can cause falls

Preventive Strategies: Reducing the Risk of Falls and Fractures

Fortunately, many falls and fractures can be prevented by taking proactive steps to maintain overall health and safety. Here are some key strategies:

Stay Physically Active

Regular exercise, such as walking, strength training, and balance-focused activities like yoga or tai chi, can help improve muscle strength, flexibility, and stability, reducing the risk of falls. Weight-bearing exercises can also help slow bone loss from osteoporosis, a condition that makes bones more fragile and prone to breaking.

Fall-Proof Your Home

Making simple home modifications, such as removing tripping hazards, installing grab bars in the bathroom, and ensuring adequate lighting, can significantly reduce the likelihood of falls within the home environment.

Manage Medications and Health Conditions

Regularly reviewing and monitoring the side effects of medications, as well as managing any underlying health conditions that can contribute to balance problems or dizziness, are crucial steps in preventing falls.

Improve Vision and Hearing

Keeping up with regular eye and hearing exams, and wearing corrective lenses or hearing aids as prescribed, can help older adults maintain their senses and reduce the risk of falls.

Prioritize Sleep and Hydration

Getting enough sleep and staying hydrated can help older adults maintain their balance and coordination, reducing the risk of falls. Limiting alcohol intake is also recommended, as it can impair balance and judgment.

Use Assistive Devices Properly

If your doctor recommends using a cane, walker, or other assistive device, be sure to use it correctly and ensure it is the right size and fit for your needs.

Empowering Older Adults: Overcoming the Fear of Falling

Many older adults may avoid physical activity due to a fear of falling, but this can actually increase the risk of falls and further decline in health. Encouraging older adults to stay active and providing education on fall prevention strategies can help them feel more confident and less fearful about the prospect of falling.

Collaborating for Safer Environments

Falls and fractures in older adults are a significant public health concern, but they can be prevented through a combination of individual actions and broader community efforts. Healthcare providers, policymakers, and community organizations can work together to create safer environments and promote fall prevention programs that empower older adults to maintain their independence and quality of life.

Conclusion: Taking Proactive Steps for Healthier Aging

By understanding the causes of falls, implementing preventive strategies, and addressing the fear of falling, older adults can take proactive steps to maintain their physical and mental well-being, and continue to enjoy an active and fulfilling lifestyle. Remember, falls are not an inevitable part of aging, and with the right approach, older adults can reduce their risk and enjoy a safer, more independent future.

Falls and Fractures in Older Adults: Causes and Prevention

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A simple accident like tripping on a rug or slipping on a wet floor can change your life. If you fall, you could break a bone, which thousands of older adults experience each year. For older people, a broken bone can also be the start of more serious health problems and can lead to long-term disability.

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If you or an older adult in your life has fallen, you’re not alone. More than one in four people age 65 years or older fall each year. The risk of falling — and fall-related problems — rises with age. However, many falls can be prevented. For example, exercising, managing your medications, having your vision checked, and making your home safer are all steps you can take to prevent a fall.

Many older adults fear falling, even if they haven’t fallen before. This fear may lead them to avoid activities such as walking, shopping, or taking part in social activities. But staying active is important to keeping your body healthy and actually helps to prevent falls. So don’t let a fear of falling keep you from being active! Learn about what causes falls and how to lower your risk of falling so you can feel more comfortable with staying active.

What causes falls in older adults?

Many things can cause a fall.

• Your eyesight, hearing, and reflexes might not be as sharp as they were when you were younger.
• Certain conditions, such as diabetes, heart disease, or problems with your thyroid, nerves, feet, or blood vessels can affect your balance and lead to a fall.
• Conditions that cause rushed movement to the bathroom, such as incontinence, may also increase the chance of falling.
• Older adults with mild cognitive impairment or certain types of dementia are at higher risk of falling.
• Age-related loss of muscle mass (known as sarcopenia), problems with balance and gait, and blood pressure that drops too much when you get up from lying down or sitting (called postural hypotension) are all risk factors for falling.
• Foot problems that cause pain, and unsafe footwear such as backless shoes or high heels, can also increase your risk of falling.
• Some medications can increase a person’s risk of falling because they cause side effects such as dizziness or confusion. The more medications you take, the more likely you are to fall.
• Safety hazards in the home or community environment can also cause falls.

Steps to take to prevent falls

If you take care of your overall health, you may have a lower chance of falling. Most of the time, falls and accidents don’t just happen for no reason. Here are a few tips to help lessen your risk of falls and broken bones, also known as fractures:

Read and share this infographic and help spread the word about how to help prevent falls.

• Stay physically active. Plan an exercise program that is right for you. Regular exercise improves muscles and makes you stronger. Exercise also helps keep your joints, tendons, and ligaments flexible. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis, a disease that makes bones weak and more likely to break
• Try balance and strength training exercises. Yoga, Pilates, and tai chi can all improve balance and muscle strength. You can also try lifting weights or using resistance bands to build strength. Learn more about different types of exercises to improve balance and strength.
• Fall-proof your home. Check out these tips for changes you can make to your home that will help you avoid falls and ensure your safety.
• Have your eyes and hearing tested. Even small changes in sight and hearing are linked to an increased risk for falls. When you get new eyeglasses or contact lenses, take time to get used to them. Wear your glasses or contacts as your eye doctor advises. If you have a hearing aid, be sure it fits well and wear it.
• Find out about the side effects of any medicines you take. If a drug makes you sleepy or dizzy, tell your doctor or pharmacist.
• Get enough sleep. If you are tired, you are more likely to fall.
• Avoid or limit alcohol. Too much alcohol can lead to balance problems and falls, which can result in hip or arm fractures and other injuries.
• Stand up slowly. Getting up too quickly can cause your blood pressure to drop. That can make you feel wobbly. Get your blood pressure checked when lying and standing.
• Use an assistive device if you need help feeling steady when you walk. Using canes and walkers correctly can help prevent falls. If your doctor tells you to use a cane or walker, make sure it’s the right size for you. Walker wheels should roll smoothly. If you borrow walking support equipment from a friend, ask your health care provider to make sure the equipment is the correct size and is safe to use. This is exceptionally important when you’re walking in areas you don’t know well or where the walkways are uneven. A physical or occupational therapist can help you decide which devices might be helpful and teach you how to use them safely.
• Take extra caution when walking on wet or icy surfaces. These can be very slippery! Use an ice melt product or sand to clear icy areas by your doors and walkways.
• Keep your hands free. Use a shoulder bag, fanny pack, or backpack to leave your hands free to hold on to railings.
• Choose the right footwear. To fully support your feet, wear nonskid, rubber-soled, low-heeled shoes. Don’t walk on stairs or floors in socks or in shoes and slippers with smooth soles.
• Consider staying inside when the weather is bad. Some community services provide 24-hour delivery of prescriptions and groceries, and many take orders over the phone.
• Always tell your doctor if you have fallen since your last check-up, even if you did not feel pain when you fell. A fall can alert your doctor to a new medical problem or issues with your medications or eyesight that can be corrected. Your doctor may suggest physical therapy, a walking aid, or other steps to help prevent future falls.

What to do if you fall

Whether you are at home or somewhere else, a sudden fall can be startling and upsetting. If you do fall, stay as calm as possible and take the following steps:

• Breathe. Take several deep breaths to try to relax. Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.
• Decide if you are hurt. Getting up too quickly or in the wrong way could make an injury worse.
• Crawl to a sturdy chair. If you think you can get up safely without help, roll over onto your side. Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.
• Slowly sit down in the chair. Put your hands on the chair seat and slide one foot forward so that it’s flat on the floor. Keep the other leg bent so the knee is on the floor. From this kneeling position, slowly rise and turn your body to sit in the chair.
• Get help. If you are hurt or cannot get up on your own, ask someone for help or call 911. If you are alone, try to get into a comfortable position and wait for help to arrive. Prepare for a fall by keeping a well-charged cordless or mobile phone with you at all times and arrange for daily contact with a family member or friend. Emergency response systems are another option: These systems enable you to push a button on a special necklace or bracelet to call for help. Some smartwatches also have this feature.

Keep your bones strong to prevent fall-related fractures

Having healthy bones won’t necessarily prevent a fall, but if you do fall, healthy bones may help prevent serious injury, such as breaking a hip or other bone. Bone breaks and fracture can lead to a hospital or nursing home stay, long-term disability, or even death. Getting enough calcium and vitamin D can help keep your bones strong. So can staying active. Try to get at least 150 minutes per week of physical activity.

Other ways to maintain bone health include quitting smoking and avoiding or limiting alcohol use. Tobacco and alcohol use may decrease your bone mass and increase your chance of fractures. Additionally, try to maintain a healthy weight. Being underweight increases the risk of bone loss and broken bones.

Osteoporosis is a disease that weakens bones, making them thin and brittle. For people with osteoporosis, even a minor fall may be dangerous. Talk to your doctor about osteoporosis.

Falls are a common reason for trips to the emergency room and for hospital stays among older adults. Many of these hospital visits are for fall-related fractures. You can help lower your risk of fractures by keeping your bones strong and following the tips above to avoid falls.

For more information

Centers for Disease Control and Prevention (CDC)
800-232-4636
888-232-6348 (TTY)
[email protected]
www.cdc.gov

National Resource Center on Supportive Housing and Home Modifications
213-740-1364
homemods@usc. edu
www.homemods.org

Rebuilding Together
800-473-4229
[email protected]
www.rebuildingtogether.org

National Falls Prevention Resource Center
571-527-3900
www.ncoa.org/center-for-healthy-aging/falls-resource-center/

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
September 12, 2022

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Preventing Falls at Home: Room by Room

Many falls happen at home, where we spend much of our time and tend to move around without thinking about our safety. There are many changes you can make to your home that will help prevent falls and better ensure your safety.

On this page:

Floors, stairways, and hallways

• Ensure there are handrails on both sides of any stairs, and make sure they are secure. Hold the handrails when you go up or down stairs, even when you are carrying something. Don’t let anything you’re carrying block your view of the steps.
• Ensure there is good lighting with light switches at the top and bottom of stairs and on each end of a long hall. Consider using motion-activated lights that plug into electrical outlets and automatically turn on when you walk by them to help illuminate stairwells and pathways.
• Keep areas where you walk tidy. Don’t leave books, papers, clothes, or shoes on the floor or stairs.
• Check that all carpets are fixed firmly to the floor, so they won’t slip. Put no-slip strips, which you can buy at any hardware store, on tile and wooden floors.
• Don’t use throw rugs or small area rugs.
• Don’t walk on slippery, newly washed floors.

Bathrooms

• Mount grab bars near toilets and on both the inside and outside of your tub and shower.
• Place nonskid mats, strips, or carpet on all surfaces that may get wet.
• Remember to leave a light on in the bathroom at night or use a night light that turns on automatically in the dark.

Bedrooms

• Put night lights and light switches close to your bed.
• Keep a flashlight by your bed in case the power goes out and you need to get up.
• Place a landline or well-charged phone near your bed.

Kitchen

• Keep frequently used pots, pans, and kitchen utensils in a place where they are easy to reach.
• Clean up spills immediately.
• Prepare food while seated to prevent fatigue or loss of balance.

Outdoor spaces

• If you have steps leading to your front door, make sure they are not broken or uneven.
• Add non‐slip material to outdoor stairways.
• Keep the lawn, deck, or porch areas clear of debris, such as fallen branches.
• Consider installing a grab bar near the front door to provide balance while you are locking or unlocking the door.
• Turn on your porch light at night and if you leave during the day but plan on returning home after dark.
• In the winter, treat outdoor walkways with an ice melt product or sand to make them less slippery.

Other living areas

• Keep electrical cords near walls and away from walking paths.
• Arrange your furniture (especially low coffee tables) and other objects so they are not in your way when you walk.
• Make sure your sofas and chairs are the right height for you to get in and out of easily.
• Keep items you use often at waist level or within easy reach.
• Don’t stand on a chair or table to reach something that’s too high — use a “reach stick” instead or ask for help. Reach sticks are special grabbing tools that you can buy at many hardware or medical-supply stores. If you use a step stool, make sure it’s steady and has a handrail on top. Have someone stand next to you.
• Don’t let your cat or dog trip you. Know where your pet is whenever you’re standing or walking.
• Keep a list of emergency numbers in large print near each landline phone and save them under “favorites” on your mobile phone.

If you have fallen, your doctor might suggest that an occupational therapist, physical therapist, or nurse visit your home. These health care providers can assess your home’s safety and advise you about making changes to lower your risk of falls.

Tools to get help

Read and share this infographic and help spread the word about how to help prevent falls.

If you’re concerned about falling, set up systems to ensure you can get help if you fall. One option is installing an emergency response system. If you fall or need emergency help, you push a button on a special necklace or bracelet to alert 911. There is a fee for this service, and it’s usually not covered by insurance.

Another option is to carry a well-charged cordless or mobile phone with you as you move throughout the house. Have close friends and family on speed dial. Consider setting up a smart home device (a small speaker that listens and responds to commands when you call its name) that can quickly connect you to contacts or emergency response teams. Some smartwatches can be set up to make emergency calls at the push of a button and others can even detect sudden fall-like movements and automatically call for help. Ask family and friends for help setting up these tools.

Home improvement resources

Many state and local governments have education and/or home modification programs to help older people prevent falls. Check with your local health department, search the Eldercare Locator, or call 800-677-1116 to find your local Area Agency on Aging to see if there is a program near you.

Read more about falls and falls prevention.

Read about this topic in Spanish. Lea sobre este tema en español.

For more information

National Resource Center on Supportive Housing and Home Modifications
213-740-1364
homemods@usc. edu
www.homemods.org

Rebuilding Together
800-473-4229
[email protected]
www.rebuildingtogether.org

Centers for Disease Control and Prevention (CDC)
800-232-4636
888-232-6348 (TTY)
[email protected]
www.cdc.gov

National Center for Injury Prevention and Control                                                                                                           
Centers for Disease Control and Prevention
800-232-4636
888-232-6348 (TTY)
[email protected]
www.cdc.gov/injury

National Falls Prevention Resource Center
571-527-3900
www.ncoa.org/center-for-healthy-aging/falls-resource-center/

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed:
September 12, 2022

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