Falls are the most common cause of injury among adults aged 65 and older. The CDC reports that each year, there are approximately 3 million emergency department visits and one million hospitalizations related to an older adult falling[2]. Additionally, 10% of falls result in bodily injury that results in restriction of daily activities, and in 2019 approximately 88% of hip fractures evaluated in the emergency room were due to a fall[2]. In the past decade, researchers have used data from the National Electronic Injury Surveillance System and the Behavioral Risk Factor Surveillance System to gather more information about what risk factors prevent falls and what fall prevention strategies yield the best results. Below is some information to help you identify risk factors for falls and prevention strategies that can be implemented to reduce fall risk.

For the best fall prevention strategy, it is important to understand what risk factors impact you or your loved one. Researchers have identified several risk factors that increase an individual’s likelihood of falling. Below is a list of common risk factors that increase likelihood and severity of falls in adults aged 65 and older: 

• Conditions affecting Blood Pressure; such as Hypertension or high blood pressure, and postural hypotension, a dip in blood pressure upon standing that results in dizziness [4] [5] 
• Chronic Disease such as Diabetes Mellitus, Obesity, and Cancer [5] 
• Muscle weakness, especially in the legs [4] [2] 
• Gait Disturbances/Abnormal walking pattern [4] [2]  
• Poor Diet / Malnutrition [1]  
• Problems with balance [4] [2] 
• Problems with vision [4] [2] 
• Shortness of breath [2]
• Improper/Poor fitting shoes [4] [2]

Prevention strategies examine what protective factors can be implemented to reduce the risk of falls in older adults. Many prevention strategies are things most people can do, while some — like installing grab bars — may cost money. Each of these strategies has been shown to reduce the risk of fall[4] and prove to be worthwhile investments. 

• Improve Lighting Inside the Home — Well lit areas reduce the likelihood of falling over objects hidden in the dark. This is especially important in paths you use at night, such as between the bed and bathroom. Add night lights in areas where someone may travel at night, such as hallways, bathrooms, and kitchens. Replace any light bulbs as soon as they go out.

• Maintain Clean & Clutter-free Floors — Tidying a living space can improve the safety in your home by ensuring the floors are free of debris, clothing items, clutter, and spills. Consider assigning a space set aside specifically for things that otherwise end up in walkways, such as shoes or reusable grocery bags. You can also ensure any wires are out of walkways by taping them down or using clips to anchor them to the wall. Finally, ensure any spills are cleaned right away. 

• Eliminate or Anchor Rugs — Throw rugs can be a beautiful addition to any home; however, when it comes to homes where a resident may be at risk for a fall, it is important to ensure they are not a fall hazard. The most recommended strategy is to eliminate throw rugs completely. If you or other people living in the house do not want to remove the rugs, many online stores have options for non-slip pads that fit neatly beneath throw rugs, or adhesive pads to stick rugs to the floor. If any rugs have upturned edges that are frequently caught on shoes, remove them from the home. 

• Be Mindful of Footwear — Some shoes, especially slip-ons and flip flops, snag on stair edges, floor seams, rugs, door thresholds, and other everyday objects. Ensure shoes are well fitted, and consider investing in non-slip soles or shoes. Supportive shoes are an important addition to any closet. 

• Utilize Assistive Devices and Mobility Aids — Assistive devices can be wonderful investments that enable older adults to stay in their home and increase safety. There are a variety of assistive devices, including toilet risers, grab bars for showers and tubs, and even couch canes that provide support for those experiencing muscle weakness or dysfunction. Mobility Aids also have a variety of designs for different needs and ailments. Your primary care provider or a physical therapist can help you decide which device is best for you or your loved one and demonstrate how it is used most effectively. 

• Avoid Excessive Use of Alcohol, Tobacco, and Cannabis — Recreational drugs like alcohol, nicotine, and cannabis are known to impair judgment and balance. Additionally, smoking any substance has a negative effect on lung capacity, leading to an increase in feeling short of breath. Each of these factors increases a person’s fall risk. A study published in 2023 found that among adults who were 65 or older and went to the ER after a fall, head injuries were more prevalent in those who had drank to the point of intoxication [6]. Moderation of these substances is crucial to fall prevention and overall health. 

• Maintain a Healthy Diet — A healthy diet promotes healthy bones, muscles, and gives the body energy. As we age, the needs of our bodies can change slightly, and health conditions can impact our nutritional needs. Talk with your primary care provider or a nutritionist about ways you can improve your diet to promote limb strength and overall well being. 

• Increase Physical Activity — Physical activity helps build strength, coordination, balance, and flexibility, and consequently reduce a person’s risk for a fall injury. A physical therapist can help by giving an individual a home exercise plan tailored to their ability and needs. Low impact exercises are also a great addition to an older person’s routine. A few good examples of low impact activities include walking, water aerobics, and tai chi.

• Be Mindful of Medications — Some medications have side effects that increase fall risk. Review the side effects of medications you take, and let your primary care provider or health care team know of any symptoms such as dizziness upon standing or feelings of lightheadedness. 

At Synergy Physical Therapy and Wellness, we offer gait training and individualized treatment to help you improve strength, flexibility, balance, and coordination. If you are worried that your physical limitations are increasing your risk for a fall, or if you have suffered an injury due to a fall, we can help! For more information on how we can help you or a loved one, call and schedule an appointment today.

 Written by Caiden McPherson 

The information in this article is intended for educational use only and is not intended to diagnose, treat, or cure any medical condition. Always consult a healthcare professional before making any decisions related to your health.

Works Cited

[1] Eckert, C. D., Tarleton, E. K., Pellerin, J., Mooney, N., & Gell, N. M. (2022). Nutrition Risk is Associated With Falls Risk in an Observational Study of Community-Dwelling, Rural, Older Adults. Journal of Aging and Health, 34(6–8), 1125–1134. https://doi.org/10.1177/08982643221096944

[2] Facts about falls. (2024, May 9). Older Adult Fall Prevention. https://www.cdc.gov/falls/data-research/facts-stats/index.html

[3] Moreland, B., Kakara, R., & Henry, A. (2020). Trends in nonfatal falls and Fall-Related injuries among adults aged ≥65 years — United States, 2012–2018. MMWR Morbidity and Mortality Weekly Report, 69(27), 875–881. https://doi.org/10.15585/mmwr.mm6927a5

[4] Moreland, B. L., Kakara, R., Haddad, Y. K., Shakya, I., & Bergen, G. (2020). A descriptive analysis of location of older adult falls that resulted in emergency department visits in the United States, 2015. American Journal of Lifestyle Medicine, 15(6), 590–597. https://doi.org/10.1177/1559827620942187

[5] Namoos, A. M., Thomson, N., Bradley, S., & Aboutanos, M. (2024). The impact of demographics and comorbidities on fall incidence and prevalence in older adults. Research Square (Research Square). https://doi.org/10.21203/rs.3.rs-4762014/v1

[6] Yuan, K., Haddad, Y., Law, R., Shakya, I., Haileyesus, T., Navon, L., Zhang, L., Liu, Y., & Bergen, G. (2023). Emergency department visits for Alcohol-Associated falls among older adults in the United States, 2011 to 2020. Annals of Emergency Medicine, 82(6), 666–677. https://doi.org/10.1016/j.annemergmed.2023.04.013