Why Do Older Adults Have More Falls?

Falls happen often among older adults over the age of 65. Every year, 3 million older adults are treated in emergency departments for injuries related to falling. With over 800,000 hospitalizations due to fall injuries like hip fractures or head injuries, falls are also dangerous.  

While falls are common among older adults, there are steps you and your family can take to help prevent an unnecessary fall. 

Cause of Falls in Older Adults

Falls are the most common cause of injuries among older adults. Up to 35% experience a significant fall every year. The prevalence of traumatic falls rises to nearly 45% among older adults over the age of 70.

Risk Factors

What causes older adults to fall? If you have one or more risk factors, you are more likely to fall multiple times. Risk factors include:

  • Previous history of falling
  • Use of assistive devices like walkers or canes
  • Poorly lit environments
  • Cluttered environments
  • Health conditions that cause muscle weakness
  • History of vertigo
  • Issues with balance or walking
  • Trouble seeing or hearing
  • Decrease in cognitive ability
  • Diabetes
  • Osteoporosis

Medication

Beyond environmental and health-related factors, some studies link certain medications to an elevated risk of falling among older adults. For example, psychotropic drugs like hypnotics or sedatives can affect balance and coordination among older adults. Drowsiness from sedatives can make a fall much more likely. Antipsychotics and antidepressants can have a similar impact. 

Taking antihistamines can also raise the risk of a fall. Many older adults experience blurred vision or cognitive impairment from cardiovascular medication that makes it easier to stumble or fall. Cardiovascular medication, such as beta-blockers or diuretics, can lead to increased hypotension, dizziness, and lightheadedness — all factors that contribute to falling. 

Treatment of Falls

Falls cause a wide range of injuries and psychological effects. While not all falls are serious, one out of every five older adults who fall experiences a traumatic injury. Common injuries from falling include:

  • Broken bones in the wrist, arm, or ankle
  • Severe hip fractures
  • Head injuries 

If you're an older adult and you fall, you should seek medical attention — especially if you hit your head. Falls are a common cause of traumatic brain injuries and should be treated proactively. Many injuries caused by a fall are treated with hospitalization and physical therapy. Injuries from a fall can have devastating effects, making it hard for you to get around on your own or live independently. 

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How to Prevent Falls in Older Adults

When it comes to falling, some risk factors can't be avoided, but many can be modified to prevent falls. Some methods for preventing falls include:

Creating a safe environment. Because most falls happen at home, creating a safe home environment can be one of the most effective ways to prevent a fall. Items to focus on include:

  • Removing obvious tripping hazards
  • Repairing damaged stairways or walkways
  • Correcting dimly lit parts of the home
  • Carpeting slippery floors
  • Securing mats placed on tile or hard surfaces
  • Placing non-skid surfaces in bathtubs, showers, and bathrooms

Research shows that home modifications — especially under the supervision of an occupational therapist — may lower the risk of falling. Common home modifications include adding handrails in hallways, in bathrooms, along stairwells, and next to any level changes within the home. 

Staying active. Exercise helps reduce your risk of falling. Exercises or training that help with gait, strength, and balance have been shown to lower the risk of falling and fall-related injuries. Programs like Tai Chi or walking groups can help you stay active.  

If you fall once you might develop a fear of falling again, which leads to limited activity. While this is common, it actually increases the risk of a second fall. Instead, focus on maintaining mobility and confidence in moving safely around your home. 

Wearing the right footwear. Foot pain and inadequate footwear contribute to many falls. Walking barefoot, in socks, or in slippers can be dangerous for older adults. Instead, wearing shoes with a low heel and slip-resistant soles can help prevent falls. 

Correcting vision. Vision impairment makes it difficult to judge distance, see tripping risks, or recognize slippery surfaces. Because of this, correcting vision with surgery, like cataract repair, can help prevent falls. Maintaining up-to-date glasses or contact prescriptions is also an important preventative step to take as an older adult.

WebMD Medical Reference Reviewed by Dan Brennan, MD on March 16, 2021

Sources

SOURCES:

Centers for Disease Control and Prevention: “Facts About Falling.”

Current Trauma Reports: “Older Adult Falls: Effective Approaches to Prevention.”

Journal of Family & Community Medicine: “Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh.”

Pharmacy Practice Granada: “Falls in the elderly: assessment of prevalence and risk factors.”

World Health Organization: "A Global Report on Falls Prevention: Epidemiology of Falls." 

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