What causes falls in older adults? What steps can be taken to prevent falls and fractures in older adults? Learn about the risk factors and practical tips to stay safe.

Understanding the Risks of Falls in Older Adults

As we age, our eyesight, hearing, and reflexes may not be as sharp as they once were. Certain health conditions, such as diabetes, heart disease, or problems with the thyroid, nerves, feet, or blood vessels, can also affect balance and increase the risk of falls. Older adults with mild cognitive impairment or certain types of dementia are also at higher risk of falling.

Age-related loss of muscle mass (sarcopenia), balance and gait issues, and postural hypotension (a sudden drop in blood pressure when standing up) are additional risk factors for falls. Foot problems, unsafe footwear, and certain medications that cause dizziness or confusion can also contribute to an increased risk of falling. Additionally, environmental hazards in the home or community can also lead to falls.

Practical Steps to Prevent Falls and Fractures

Fortunately, there are several steps older adults can take to reduce their risk of falls and fractures. Staying physically active through exercises that improve muscle strength, balance, and flexibility, such as walking, yoga, Pilates, and tai chi, can help maintain overall health and prevent falls.

Ensuring your home is safe and “fall-proof” by making modifications like removing tripping hazards, improving lighting, and installing handrails can also go a long way in preventing falls. Regular eye and hearing check-ups, as well as reviewing the side effects of any medications you take, are important to address potential contributing factors.

The Importance of Balance and Strength Training

Balance and strength training exercises are particularly crucial in reducing the risk of falls. Activities like yoga, Pilates, and tai chi can improve balance and muscle strength, while weight-lifting and resistance band exercises can help build overall strength.

These types of exercises not only improve stability and coordination, but they may also help slow down bone loss from osteoporosis, a condition that makes bones weaker and more prone to fractures.

Addressing Medication Concerns

Certain medications can increase the risk of falls due to side effects like dizziness or confusion. It’s important to discuss any potential medication-related fall risks with your healthcare provider. They may be able to adjust your dosage or find alternative medications that are less likely to cause these issues.

Additionally, ensuring you get enough sleep and limiting alcohol intake can help reduce the risk of falls, as fatigue and impaired balance can contribute to accidents.

The Role of Assistive Devices

If your healthcare provider recommends using a cane or walker, it’s important to use it correctly and ensure the equipment is the right size and fit for you. Properly using assistive devices can help you feel more steady and confident when walking, reducing the likelihood of falls.

Remember, falls and fractures are not an inevitable part of aging. By taking proactive steps to maintain your health, address potential risk factors, and create a safer environment, you can significantly reduce your risk of experiencing a debilitating fall.

The Lasting Impact of Falls and Fractures

A fall, even a seemingly minor one, can have serious consequences for older adults. A broken bone, such as a hip or arm fracture, can be the start of more severe health problems and lead to long-term disability. This can dramatically impact an individual’s quality of life, independence, and overall well-being.

Therefore, it’s crucial for older adults and their caregivers to prioritize fall prevention and take the necessary steps to maintain safety and reduce the risk of these life-altering events.

Empowering Older Adults to Stay Active and Engaged

Many older adults may avoid certain activities due to a fear of falling, but staying active is important for overall health and can actually help prevent falls. By addressing the underlying causes of falls and taking proactive measures, older adults can feel more confident and comfortable in maintaining an active lifestyle.

This not only benefits their physical health but also their mental well-being, as social engagement and a sense of independence are important for the overall quality of life in the golden years.

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

Related Articles

Fall Prevention & Home Safety Tips

Falls are costly and can cause serious injury or death.

Falling, slipping or tripping around the house is a serious concern for seniors.

Each year, more than one out of four adults age 65 and older falls. These falls cause moderate to severe injuries such as cuts, broken hips or head traumas in 20 to 30 percent of people. Injuries from falls can make it hard to get around or live independently, and they can increase the risk of early death.

Facts About Falls

• Falling once doubles your chances of falling again.
• One out of five falls causes a serious injury such as broken bones or a head injury.
• Each year, 3 million older people are treated in emergency departments for fall injuries.
• Over 800,000 patients a year are hospitalized because of a fall injury.
• Among older adults, falls are the leading cause of both fatal and nonfatal injuries.
• Most fractures among older adults are caused by falls.
• The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
• Falls are the most common cause of traumatic brain injuries (TBI).
• Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker and this increases their chances of falling.
• The chances of falling and of being seriously injured in a fall increase with age.
• Men are more likely than women to die from a fall. After taking age into account, the fall death rate is approximately 40% higher for men than for women.

* According to the Centers for Disease Control and Prevention

Falls Prevention Resources

Falls Prevention Video

See small, inexpensive steps to take to make a home safer.

Falls Free CheckUp

Take this 2-minute Falls Free CheckUp to see what causes falls and how to prevent them.

Indiana Fall Prevention Coalition

Improving the well-being of Indiana older adults by raising awareness of fall prevention.

Help Prevent Fall Risks

This handout from INFPC offers exercises to reduce the risk of falls and a home assessment checklist.

6 Steps to Protect Your Loved One

If you have an aging parent, grandparent or neighbor in your life, help them reduce their risk of falling.

National Council on Aging: Falls Prevention

NCOA’s Resource Center supports the implementation of evidence-based falls prevention programs.

Home Safety Tips

• Don’t rush when doing a task. Accidents are more likely to occur when you are in a hurry.
• When changing positions, such as standing from a sitting position, count to 15 before starting to walk.
• Wear supportive shoes that have low heels and rubber soles: smooth-soled shoes, slippers or only wearing socks can increase your chances of falling.
• Make sure dresses, nightgowns and trousers are short enough in length to avoid tripping over them when walking. Also, be sure to roll back long, loose sleeves or fasten them with pins when cooking.
• Do you take four or more medications daily? Multiple medications can cause dizziness, drowsiness and balance problems. It is important to have all of your medications reviewed at least once a year by a pharmacist or doctor.
• Have your vision checked regularly/annually. Wear glasses as advised by your eye doctor.
• Have you or those around you noticed a change in your hearing? Dizziness can occur with hearing loss. Set up an appointment to have your hearing checked.
• Have daily contact with a family member, friend and/or neighbor. Also, consider having a home alert system installed.

Home Safety Modifications

BEDROOM

• Move bedside items/tables closer and arrange the room so that there is a direct path in/out and to the bathroom.
• Place night-lights in all bedrooms and bathrooms. Use night-lights that turn on automatically as the room becomes dark.
• Always keep a charged flashlight near your bed for emergencies.

BATHROOM

• Consider using a shower chair, tub-mounted grab bars and raised toilet seats with hand rails to assist with sitting and standing, hand-held shower attachment or wearing “aqua shoes.”
• Use non-slip mats in the bathtub and on the shower floor.

KITCHEN

• Store commonly used items on shelves that are easy for you to reach. If you must reach overhead, keep a sturdy stool handy.
• Eliminate throw rugs, if possible. If necessary, use rugs with a nonskid backing or add double-sided carpet tape around edges.

STAIRS

• Install handrails on both sides of the steps. They should run the full length of the steps.
• Mark the top and bottom steps for better visibility with bright contrasting tape or paint.
• Be sure stairs are well-lit and light bulbs are checked regularly to be in working order. Install light switches at the top and bottom of stairs.

OUTSIDE

• Install sturdy handrails for all steps or, if necessary, a ramp with handrails.
• Also, make sure your porch has proper lighting and consider fixing uneven sideways/pathways.

Ready to reduce the risk of falls in your home?

We’re here to help. If you’re interested in home accessibility modifications and eligibility criteria, contact us today!

Safety measures in case of snow melting and icicles falling from the roofs of buildings

• Main
• Administration of the city of Norilsk
• Divisions
• Department of Civil Defense and Emergency Situations of Norilsk
• Useful information

In winter and spring, on the roofs of buildings,
accumulate a large amount of snow, and icicles may also form,
which reach a considerable size. Especially dangerous now
roofs and cornices decorated with “garlands” of ice icicles. Hanging from the rooftops, they
threaten human health and life.

The fall of a “sharp-nosed” ice on a person is fraught, at best
case, injuries of varying severity. It all depends on the altitude and
icicle size. There are cases when a dangerous “decoration” killed
passersby.
Every year, falling icicles claim the lives of dozens of Russians. There were cases that
icicles fell into a baby carriage left under a murderous “garland”.
It is clear that only a miracle saved the children from death. We just think that
icicles tightly “grow” to the roofs. In fact they are ready to fall in
any moment. Light thaw, wind and ice tend to fall on the heads
pedestrians.

To avoid accidents due to falling
icicles, you need to be careful, try not to move close to
walls of buildings, under balconies. It is worth avoiding the place of a possible fall
icicles or snow layers from the roof.

Being in the danger zone, a person can get hit by a falling
snow and icicles are very serious and dangerous injuries and even death.

To avoid this situation, you should:

• do not approach the roofs of buildings from which exit is possible
  snow, and not allow children to be in such places;

• warn children of danger. Playing under a dangerous roof
  may end sadly;

• in the presence of a fence, warning notices
  (signs) of a dangerous place, do not try to pass over the fence, go around
  dangerous place in another way;

• after falling snow, ice (icicles) from the edge of the roof, snow and
  ice can also come off the rest of the roof, so if you can see on the sidewalk
  traces of previously fallen snow, or ice fragments, this indicates a danger
  this place;

• if you heard upstairs while driving on the sidewalk
  suspicious noise – you can not stop, raise your head and look,
  what happened there. Perhaps this is the melting of snow or ice blocks. Run away from the building
  is also impossible, you need to snuggle up to the wall as quickly as possible, the roof peak will serve
  shelter;

• if an icicle or snow has fallen from the roof
  man, you need to call an ambulance.

Be alert and careful when near
buildings!

Prevention of falling objects when working at height

October 28, 2019

Tools

Safety

Accessories

Your employees may be perfectly safe when working at heights, but how do you protect their colleagues below? Falling tools and other objects are a big hazard that is not always given due attention. The following are clear guidelines for securing tools, preventing tools from falling, and improving workplace safety.

Problem:

Technicians in the metalworking and energy industries often work at heights. They have to climb to great heights to maintain a wind turbine or a high-rise building. Dropping even a small object in such a situation can cause serious injury. In the US alone, according to OSHA (Occupational Health and Safety Administration), more than 50,000 people are injured each year as a result of falling objects.

From a legal point of view:

US law requires employers to educate and inform employees, both permanent and temporary, about workplace hazards. They are also required to take steps to prevent accidental dropping of equipment. If this is not possible, employers should provide a safe area under the work at height and keep people out of it. It is important to note that this approach should only be used as a last resort. The UK and other countries have similar laws. There is a conflict between traditional practice and legal requirements. Often the area under the work site is blocked off by fences, and people cannot walk there and be hit by falling objects. The main purpose of legislative measures, on the contrary, is to prevent the very fact of such falls.

When working at height, do not rely on the fenced area below to provide sufficient protection. The first step is to prevent the tools from falling.

Harald Odenman
,
Marketing Manager at Chicago Pneumatic

Tool Drop Prevention Measures

First of all, it is important to remember that wearing helmets is not enough. They should always be worn anyway, but they can only provide partial protection. Falling objects, except perhaps the smallest ones, can still cause injury. As we have said, fences should only be used in extreme cases. The correct solution is to implement special procedures and equipment designed to provide additional safety and prevent the tool from falling.

Essential tips for operators working at height

• Seek specialized training – employer must provide it
• Place items in securely closed containers or lifting bags and secure them to the attachment point at the top. Use hoists and cranes to lift equipment, not to move it. Do not climb ladders or other structures with tools in your pockets:
  • We recommend that you attach items weighing less than 2. 25 kg to your clothing using a tool belt, clips, cords or other means of attachment – or carry them in a secure case
  • We recommend securing equipment weighing more than 2.25 kg at a suitable attachment point on a stable structure, but do not attach to an employee!
  • This recommendation applies to phones, radios, tablets, laptops, tape measures and other devices.
• Be sure to bring all the correct tools, accessories and accessory changing equipment needed for the job (eg see our impact wrench bit recommendations). If necessary, replace accessories and consumables before lifting, but not at height.

General recommendations:

• Be sure to use all recommended protective equipment, including fall arrest devices, helmets, gloves and other PPE tools suitable for explosive atmospheres

Top Tips for Employers to Prevent Tool Drops

• Train operators first on agreed safety procedures
• Incorporate falling objects into safety training
• Consider falling objects as part of your workplace safety risk assessment
• Take action to address identified risks
• Provide operators with all the facilities listed in the previous list, including fixtures and anchor points, lifting gear and protective equipment
• Set up a safety net in a working area or fence off an area
• Keep up to date with new developments in safety equipment

Fall protection training must consider both the possibility of falling objects and the possibility of falling people.