Frequently Asked Questions

How common are falls among older people?

More than one in three people age 65 years or older fall each year. The risk of falling -- and the risk of disability and other life-changing problems caused by falls -- increase with age. Falls are not an inevitable part of getting older, though. Many falls can be prevented.
Why do people fall?

People fall for many reasons. Often, more than one risk factor is involved in a fall. As the number of risk factors rises, so does the risk of falling.
Many falls are linked to personal factors -- a person's physical condition or medical problems. Falls may also be linked to safety hazards in the person's home or community environment.
What personal factors can lead to falls?
Some personal factors that can lead to falls are

muscle weakness, especially in the legs
poor balance or difficulty walking -- factors that could be related to a neurological cause, arthritis, or another condition that might be treated.
blood pressure that drops too much on standing
vision problems
taking medications that cause side effects like dizziness and confusion, or that interact with one another.
Impaired mental abilities and urinary incontinence may also contribute to falls.

What environmental factors can lead to falls?
Some environmental factors that can lead to falls are

clutter and other tripping hazards
slick floors, loose rugs, and slippery walkways
poor lighting, either inside or outdoors
not having handrails along stairs and grab bars in the bathroom.

How do falls affect people?

Falls most often result in bruises or minor cuts, but they sometimes affect a person's physical or mental well-being. At least one-tenth of falls result in serious injury to soft tissues or bones. A fall can cause a fracture, head injury, or other problem that can change a person's life.

Fractures caused by falls can lead to hospital stays and disability. They can also prevent a person from getting around, doing daily tasks, or socializing. Most often, fall-related fractures are in the person's hip, pelvis, spine, arm, hand, or ankle.
Fear of falling again can cause problems. A person who has fallen may avoid doing daily tasks or enjoyable activities. This fear can also cause the person to spend more time at home, away from other people.
How common are hip fractures, and what problems do they cause?
Hip fractures are a common and very serious type of fall-related injury among older adults. These fractures are a leading cause of medical problems, loss of independence, and death. Only half of older adults hospitalized for a broken hip will be able to get around as they did before the hip fracture. Many will need long-term care.
What is osteoporosis and who gets it?
Osteoporosis is a disease that involves loss of bone mass. Over time, this disease thins and weakens bones to the point where they break easily, especially in the hip, spine, and wrist. Low bone mass increases the chance of hip fractures and other fractures if you fall. If bones are fragile, even a minor fall can cause fractures.

More than two-thirds of people with osteoporosis are women, but men can also have it. Small, thin-boned women and women who are Caucasian or Asian are at greatest risk.
How do I know if I have osteoporosis?

Osteoporosis has no symptoms. Many people don't know they have it until a bone breaks. A bone density test can tell you if you are at risk. This safe, painless test uses X-rays or sound waves to measure the strength of your bones. Women over age 65 and men over 70 should have a bone density test.
How can I improve my bone health?

Getting enough calcium and vitamin D, and staying physically active can help keep bones healthy and prevent bone loss. Not smoking and limiting the amount of alcohol you drink can help, too. Your doctor might also recommend taking medicines to slow bone loss or help rebuild bone if you are at risk of osteoporosis.
How much calcium and vitamin D do I need to keep my bones strong?
People over age 50 should consume 1,200 mg of calcium daily by eating calcium-rich foods and taking calcium supplements. People ages 51 to 70 should consume at least 400 international units (IU) of vitamin D daily. People over age 70 should consume at least 600 IU daily.
Can medications increase my risk of falling?

People who take at least four prescription drugs have a greater risk of falling than do people who take fewer drugs. Sometimes the increased risk comes from the health problems for which the person takes the medications. In other cases, the effects of the medications themselves increase a person's risk of falls.

Certain medications cause side effects like dizziness, confusion, and sleepiness that increase a person's risk of falling. Some medications don't work well together and may cause problems that lead to falls.

If you think your medicines are causing problems, don't stop taking them unless you talk with your doctor first. Also, be sure to talk with your doctor about your risk of falls from medications.
Should I talk with my doctor about changing my medications to help prevent falls?

It is important to talk with your doctor about your medications. Bring your prescribed medicines with you when you visit the doctor. Also bring any over-the-counter products, vitamins, minerals, and herbal products you are taking.

Ask if any of the medications or other products might increase your risk of falling. Also ask if you no longer need to take any of the medicines or if the doses might be decreased.
Does physical activity increase my risk of falls?

You might think that moving about will increase the chance of falling. However, physical activity actually helps lower older adults' risk of falls.

Without the physical activity that comes with doing daily tasks or exercise, your muscles and bones can weaken over time. As a result, you could become more -- not less -- likely to fall. Talk with your doctor about what kinds of physical activity you should do.
How does exercise help prevent falls?

Getting regular exercise is one way to prevent falls and fractures that result from falls. Exercise keeps muscles strong and improves balance. It also helps keep joints, tendons, and ligaments flexible. In turn, your balance and the way you walk may improve, lowering your risk of falling.

Your doctor or a physical therapist can help you plan an exercise program that is right for you. A supervised group program can improve your balance and gait. Doing strength and balance exercises at home can also reduce your risk of falls.
Does physical activity help prevent fractures?

Regular physical activity helps slow bone loss and builds strong bones. Having strong bones can prevent fractures if you do fall. Walking, dancing, climbing stairs, gardening, and doing other physical activities at least 30 minutes a day can help keep bones healthy.
What is Tai Chi and how can it help prevent falls?

Tai Chi is an ancient Chinese method of using slow, flowing movements to coordinate the mind and body. This gentle, relaxing activity can improve strength, balance, postural alignment, and concentration.

Some studies have found that Tai Chi helps prevent falls among older people because it improves balance and control. It may also boost self-confidence and reduce the fear of falling.
Can vision problems lead to falls?

Vision problems can contribute to falls among older people. Problems that can lead to falls include

lack of depth perception or visual sharpness
not being able to see contrasting objects
cataracts
glaucoma.

What can I do to prevent vision-related falls?

Have your vision tested regularly or if you think it has changed. Even a small change in vision can increase your risk of falling.

To prevent falls, wear your eyeglasses if you need them. Keep the lenses clean and be sure the frames are straight. If you get new glasses, be extra cautious as you get used to them. If you wear reading glasses or multi-focal lenses, take them off when you're walking to avoid missteps.
What kind of footwear should I wear to help prevent falls?

Sensible footwear can help prevent falls. Choose shoes that
- have low heels and non-slip soles
- fit well -- there should be no marks on your feet when you take off your shoes and socks
- completely surround the foot -- no backless shoes
- support your feet.
Avoid wearing only socks or floppy, backless slippers. Also, be sure to wear boots with good traction if you go outside in the snow.
Where do most falls happen?
Falls can happen anywhere, but more than half of all falls happen at home. Many of these falls could be prevented by making simple changes in the home.
What can I do to prevent falls at home?

One simple way to prevent falls at home is to remove objects from stairs, hallways, and other places where you walk. Tripping on clutter, shoes, small furniture, pet bowls, electrical or phone cords, or other things can cause a fall. Be sure to arrange furniture so you have plenty of room to walk freely, too.
Can better lighting help prevent falls?

Good lighting can help prevent falls. Make sure you have adequate lighting in each room, at entrances to your home, and on stairways in your home. Light switches at both the top and bottom of stairs can help. Throughout your home, use light bulbs that have the highest wattage recommended for the fixture.

Place night lights in the bathroom, hallways, and other areas to guide you when you get up at night. You might also put a lamp within reach of your bed. Keeping a flashlight near your bed can help if the power is out and you need to get up.
What can I do to prevent falls outdoors?

Be careful when walking outdoors. Slipping on a slick sidewalk, a curb, or icy stairs could result in a disabling fracture or other injury.

To help prevent falls outdoors at home, you should
- have handrails installed on both sides of outdoor stairs and walkways
- use a cane or walker to increase your stability and walking confidence in bad weather
- light stairs and walkways
- ask someone to spread sand or salt on icy surfaces
- wear shoes or snow boots with traction when walking on slippery surfaces.
Should I use a cane to avoid falls?
Talk with your doctor or a physical therapist to find out if a walking aid will help you avoid falls. A cane or walker could make you more stable when you walk. This walking aid might be especially helpful when you're in unfamiliar places or where walkways are uneven.
If I need a cane, what size should I have?

Be sure that your cane fits you well and that you learn to use it safely. The height of a cane should allow your elbow to be at a comfortable angle. A physical therapist can help you choose the right size and type of cane and can show you how to use it properly.
Should I use a walker to prevent falls?

Ask your doctor if a walker would help you prevent falls. A walker could help you stay balanced by giving you a wide base of support. Take time to learn how to use a walker properly. Also, be sure to use the walker when needed.
How can I choose the right kind of walker if I need one?

If you need to use a walker, it is important to choose the right kind for you. It's also important to develop a habit of using any walking aid correctly. A physical therapist can help you choose a walker that meets your needs and fits you well. Two-wheeled walkers won't roll away when you put weight on the walker. Four-wheeled walkers can be used if you don't need to put your weight on the walker for balance.

When using a walker, your elbows should be at a comfortable angle of about 30 degrees. Also, when your arms are relaxed at your sides, the inside of your wrist should be at the top of the walker grip.
What should I do if I fall?

A sudden fall can be startling and frightening. If you fall, try to stay calm. Take a few deep breaths to help you relax.

Stay still on the floor or ground for a few moments to help you get over the shock of falling. It will also give you time to decide if you're hurt before getting up. Getting up too quickly or in the wrong way could make an injury worse.

If you think you can get up safely without help, you should follow these steps.
- Roll over onto your side and push yourself up into a seated position.
- Rest while your body and blood pressure adjust.
- Slowly get up on your hands and knees, and crawl to a sturdy chair.
- Put your hands on the chair seat and slide one foot forward so that it is 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.
If you're hurt or can't get up, ask someone for help or call 911. If you're alone, try to get into a comfortable position and wait for help to arrive.
Should I tell my doctor if I fall?

Yes. Be sure to tell your doctor if you fall or almost fall, even if you aren't hurt. The fall might be a sign of an underlying problem that can be treated or corrected.

Write down when, where, and how you fell so you can discuss the details with your doctor. The doctor can assess whether a medical issue, such as low blood pressure or diabetes, or another cause of the fall should be addressed.

Knowing the cause of a fall can help you and your doctor find ways to prevent future falls. For instance, your doctor might suggest changing your medication doses or eyewear prescription.
How can I cope with my fear of falling?

Many older adults are afraid of falling. This fear becomes more common as people age, even among those who haven't fallen. Getting rid of your fear of falling can help you to stay active, maintain your physical health, and prevent future falls.

Fear of falling might cause you to avoid doing activities you enjoy or need to do. It might also cause you to stay at home, away from your friends, family, and others. In turn, you may become lonely and inactive.

If you're worried about falling, talk with your doctor. He or she may be able to help you cope with this concern by referring you to a physical therapist. A physical therapist can help you improve your balance and help build your walking confidence.
Why do I sometimes feel dizzy when I stand up?

Dizziness might be caused by postural hypotension -- a drop in blood pressure when you stand up. This condition might result from a drop in blood volume, dehydration, or certain medications. It might also be linked to diabetes, Parkinson's disease, or an infection.

Talk with your doctor if you sometimes feel dizzy when you stand up. The doctor or a nurse can check your blood pressure to find out if you have postural hypotension. Some people with postural hypotension do not feel dizzy so it is important to ask your doctor or nurse to check your blood pressure while you are lying and standing. They can also suggest ways to avoid the dizziness that could result in a fall. For instance, the doctor may suggest drinking more water or changing some of your medicine doses. There may also be other reasons for your dizziness which your doctor can help you identify.

Also, always stand up slowly after eating, lying down, or resting. Getting up too quickly can cause your blood pressure to drop.
Should I get a personal emergency response system?

If you have problems with balance or dizziness or live alone, you might want to get a personal emergency response system. This service provides a button or bracelet to wear at all times in your home.
If you fall or need emergency medical assistance for any reason, a push of the button will alert the service through the phone system. Emergency medical services will be called. There is a fee for medical monitoring services, but it may be worth the cost.

Copyright: NIHSeniorHealth.gov developed by the National Institute on Aging (NIA) and the National Library of Medicine (NLM) both part of the National Institutes of Health (NIH).