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Methods to Reduce Fall Risk in Older Adults

Methods to Reduce Fall Risk in Older Adults

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.

What Conditions Can Increase 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]

Fall Prevention Tips

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

As we age, maintaining health and independence becomes a top priority. Strength training, a type of resistance exercise often overshadowed by cardio or flexibility exercises, is a cornerstone of healthy aging. Whether you’re in your 30s or 80s, incorporating strength training into your routine can help you live a longer, more vibrant life. Here’s why everyone needs to embrace strength training and how to overcome common barriers to getting started.

1. Avoiding Frailty

Frailty, marked by reduced strength, endurance, and physical function, is a growing concern with age. According to the National Institute on Aging, frailty increases the risk of falls, disability, and hospitalization. For women, who face a higher risk of osteoporosis, frailty can also lead to fractures with prolonged recovery. Strength training combats frailty by building muscle mass and bone density. 

A 2021 study in the Journal of Clinical Medicine found that resistance training significantly improved muscle strength and reduced frailty markers in older adults. For women, this is especially critical, as stronger muscles and bones reduce the risk of osteoporotic fractures. Exercises like weightlifting, bodyweight workouts, or resistance bands enhance physical resilience, making daily tasks like carrying groceries or climbing stairs safer and easier.

(Want to know more about osteoporosis and PT’s role in it’s prevention and treatment? Check out our previous article for more information: Osteoporosis, Osteopenia, and Physical Therapy) 

2. Staying Able to Do the Things You Love

Strength training ensures you can keep enjoying activities like gardening, hiking, or playing with grandkids. According to an article in Harvard Health Publishing, muscle strength can begin to decline by about 1-2% per year after age 35 due to sarcopenia, also known as age-related muscle loss. This muscle loss accelerates as our bodies age. This loss can limit your ability to perform daily tasks or pursue hobbies, particularly for women who may experience accelerated muscle loss during menopause due to declining estrogen levels. 

Regular strength training preserves functional capacity, and benefits multiple domains of health. A  2019 study published in Frontiers in Physiology showed that resistance exercise not only improved musculoskeletal health, but also helped patients manage chronic conditions like cardiovascular disease and diabetes (Mcleod et al., 2019). Older adults who participated consistently in resistance strength exercise maintained better mobility, overall health, and independence than those who did not. Additionally, the same study found that those using light weight or only body weight while strength training was just as effective as heavy weights (McLeod et al., 2019). The most important factor of strength training for healthy aging is finding a routine that is suited to your body and your ability. A consultation with a physical therapist can help you find the right routine and guide you through proper exercise form to ensure your exercise is preventing injury, not causing it.  Strength training empowers you to stay active, healthy, and independent.

3. More Muscle Mass Equals Improved Blood Sugar Control

Building muscle isn’t just about strength—it’s about metabolic health. Muscle tissue helps regulate blood sugar by improving insulin sensitivity, which is vital for preventing or managing type 2 diabetes, a condition more prevalent with age (Mcleod et al., 2019). Increased muscle mass enhances glucose uptake, reducing blood sugar spikes. This is particularly important for women, who may face increased risks for diabetes complications. Researchers have found that  resistance training improved glycemic control in older adults with type 2 diabetes (Mcleod et al., 2019). In their review of resistance exercise and blood sugar management, resistance exercise performed for 8 weeks resulted in clinical improvements in A1C management and improvements in insulin resistance. These findings are relevant not just to individuals living with diabetes, but also those with insulin resistance, metabolic disorders, or a family history of diabetes. More muscle mass means greater glucose storage capacity, supporting overall metabolic health. Even moderate strength training, like lifting weights twice a week, can make a significant difference.

Common Barriers to Starting Strength Training

Despite its benefits, many hesitate to start strength training. Here are common barriers and solutions:

  • Lack of Knowledge: Many feel intimidated by unfamiliar exercises. 
    • Solution: Start with simple bodyweight moves like squats or push-ups. Online resources from the American Council on Exercise (ACE) offer free beginner guides, or consult a certified personal trainer for a tailored program.
  • Fear of Injury: Older adults, especially women with lower bone density, may worry about getting hurt. 
    • Solution: Begin with low weights or resistance bands under professional guidance. A 2018 study in Journal of Strength and Conditioning Research confirms supervised strength training is safe and effective for all ages when done correctly.
  • Time Constraints: Busy schedules can make exercise feel daunting. 
    • Solution: Short, 20-minute strength workouts 2-3 times per week still deliver impactful benefits, per American College of Sports Medicine guidelines.
  • Gym Intimidation: Gyms can feel overwhelming for beginners. 
    • Solution: Try home workouts with minimal equipment or join small group classes for older adults, which foster a supportive environment. Women-only classes can also provide a comfortable starting point.

Getting Started with Strength Training

To reap the benefits, aim for 3 sessions per week. Focus on compound movements—exercises that work multiple muscle groups at once, like squats, deadlifts, lunges, assisted pull-ups, and pushing-pressing motions. These maximize efficiency and functional strength. Start with light weights, resistance bands, or bodyweight exercises, gradually increasing intensity.

Safety Tip: Deadlifts, a powerful and functional movement, we commonly integrate this into out-patient rehabilitation strategy, but it does require proper technique to avoid injury. Begin with no weight, using a broomstick or similar tool to master form under a skilled coach’s guidance before adding weight. This is especially important to protect against lower back strain or injury.

Always consult a healthcare provider before starting a new exercise program, especially if you have chronic conditions like osteoporosis, chronic low back pain or shoulder problems. If you do struggle with any of these, one of our physical therapists can design a program tailored to your needs, and we’re here to support you every step of the way. If you are free from chronic conditions or pain a skilled coach or trainer can also be a great fit to get you started safely.

Strength training isn’t just for bodybuilders—it’s for everyone who values aging gracefully, staying active, and feeling their best. By building strength now, you’re investing in a healthier, more independent future.

References:

Harvard Health. (2023, February 14). Age and muscle loss. https://www.health.harvard.edu/exercise-and-fitness/age-and-muscle-loss

Mcleod, J. C., Stokes, T., & Phillips, S. M. (2019). Resistance Exercise training as a primary Countermeasure to Age-Related Chronic Disease. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00645

Talar, K., Hernández-Belmonte, A., Vetrovsky, T., Steffl, M., Kałamacka, E., & Courel-Ibáñez, J. (2021). Benefits of Resistance training in Early and late Stages of Frailty and sarcopenia: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Journal of Clinical Medicine, 10(8), 1630. https://doi.org/10.3390/jcm10081630

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