elderly man sitting with cane

Falls are a leading cause of injury in older adults and can have life-shattering consequences. With a high risk of breaking bones or experiencing other traumatic injuries, preventing falls is essential.

Falls in older adults are a cause of concern, both from a public health perspective and a lifestyle impact. The Centers for Disease Control and Prevention (CDC) reported that in 2009, 2.2 million nonfatal fall injuries in older adults (over 65 years of age) were treated in emergency departments. Of these fall patients, more than 581,000 were hospitalized. In 2007, more than 18,000 older adults died from unintentional fall injuries.

Perhaps the most damaging effect of falls is the physical and psychological impact of the fear of falling. Many older adults restrict their activities unnecessarily due to a fear of falls, which leads to a vicious cycle. Lack of physical activity causes a decrease in muscle tone and strength, which in turn leads to an increased risk of falling.

What causes falls?
Falls in older adults result from many different reasons. The Colorado State University Extension's 2005 fact sheet on "Preventing Falls in the Elderly" lists five main factors that contribute to falls:

  1. Osteoporosis: A condition where the bones become more fragile and less able to withstand stress. Osteoporosis may be caused by reduced physical activity, reduced minerals in the diet, or poor mineral and vitamin absorption.
  2. Lack of Physical Activity: Leads to a loss of skeletal muscle tone and muscle mass (sarcopenia), decreased muscle strength, and loss of bone mass and flexibility.
  3. Medications: Different medications such as sedatives, anti-depressants, and anti-psychotic drugs can reduce mental alertness, worsen balance and gait, or cause drops in blood pressure, all of which may contribute to dizziness, loss of balance, and the potential for falling. Many elderly are being prescribed statins, cholesterol-lowering medications. One of the statins' adverse effects is generalized muscle destruction called myosis.
  4. Impaired Vision: Aging effects on the eyes, such as cataracts, glaucoma, and near-sightedness can make it more difficult for older adults to safely navigate their surroundings.
  5. Environmental Hazards: Common conditions in the home, such as objects left on the floor, poor lighting, loose rugs, unsteady furniture, and lack of grab bars can also increase the risk of falls in the home.

While there are certain effects of aging that put older adults at risks for falls, such as change in vision, poor balance, and decline in muscle strength, there are many things that can be done to reduce risk. Staying active, fall-proofing the home, and using assistive devices are easy adjustments one can make to lower the risk of fall-related injury.

Tips for Preventing Falls in Older Adults
The first step in lowering your risk from a fall-related injury is to keep moving. The Centers for Disease Control and the Mayo Clinic offer useful safety tips for preventing falls in older adults.

  • Eat a Healthy Diet: Ensuring there is enough calcium and Vitamin D in the diet will help in preventing or delaying osteoporosis and maintaining bone health.
  • Stay Active: Participate in regular activity to increase muscle (leg) strength and improve balance.
  • Review Medications: Have the doctor or pharmacist review prescription and over-the-counter medications for those that may cause dizziness or drowsiness.
  • Maximize Vision: Keep yearly eye checks, to discover eye changes and update eyeglasses, if needed to improve vision.
  • Wear Good Shoes: Walking in stocking feet should be avoided, since it can increase the risk of slipping and falling. Proper fitting, sturdy, lace-up shoes with nonskid soles will help cut down on slipping and stumbling.
  • Check the Home: Go through a handy home checklist or two and look for tripping hazards. Improving lighting in the home will make it easier to see potential hazards.
  • Use Assistive Devices: Add helpful devices such as grab bars and railings to stairways, bathrooms and showers. Using a cane or a walker can help improve balance and mobility.

For More on Fall Prevention in Older Adults
Two additional resources with useful information on preventing falls come from The Fall Prevention Center of Excellence (StopFalls.org) and the Center for Healthy Aging of the National Council on Aging.

The Fall Prevention Center of Excellence works to "identify best practices in fall prevention and to help communities offer fall prevention programs to older people who are at risk of falling." On its site, there is a useful section for individuals and families, with tools and ideas that can be very helpful in preventing serious injuries due to falls in the home and in the community.

Web visitors will find carefully selected resources for healthy aging programs on the Fall Prevention section of the Center for Healthy Aging. Checklists and brochures related to home safety are also provided here.