Avoid falls with these 4 simple tips

The Bottom Line

  • Falling is not a natural consequence of aging, but is the result of several age-related factors such as loss of muscle strength and balance.
  • Improving strength and balance through exercise can decrease the risk of falls.
  • A medication review may reduce falls and injuries caused by drug side effects.
  • Consider seeing a podiatrist. 

Falls are the leading cause of injury-related hospitalizations among Canadian seniors (1) and 20% to 30% of people aged 65 and older suffer serious falls each year (2). Furthermore, older adults who fall once are more likely to fall again (2). Those are startling statistics and they represent a lot of injured people whose quality of life is also likely to take a nosedive.

You don’t have to be one of them!

Maybe you’ve already made some changes to your home environment such as installing handrails and grab bars, improving lighting and removing items that can be a tripping hazard. That’s wise, but don’t stop there. Research shows these three simple changes to your physical health can also help you stay steady on your feet. Click on the links for details about the research.

1. Build your strength

As we age our bodies often lose muscle mass and strength (a condition called sarcopenia) and the resulting weakness – particularly in the legs – is what makes us more likely to fall. But we can fight back by getting regular physical exercise that includes weight bearing activities to build and strengthen muscles.

One approach supported by research evidence is “high intensity progressive resistance strength training" (3). It’s not as complicated as it sounds: simply start exercising with a weight that is difficult but doable and increase the weight as it becomes easier.

Many different types of exercise are beneficial for building muscle mass, including working out in the pool and with elastic resistance bands (4;5). Remember: the best type of exercise is one that you enjoy, as you are more likely to stick with it and see the benefits. What’s more, exercise can also be combined with other falls prevention strategies—such as education or doing an environmental assessment and removing tripping hazards—to prevent falls (6-9).

2. Find your balance

A loss of balance is also common in older age, another reason seniors are at higher risk of falling. Once again, exercise is the remedy. Movements designed to improve balance and flexibility – including Pilates and exercises using the Nintendo Wii – can help us stand firm, or recover quickly if we begin to lose our footing (10-12). Tai chi is also recommended for its various benefits including improving strength and balance through slow controlled movements (13).

3. Take stock of your pill cupboard

With age comes wisdom… and often a lot more pills. Prescription and over-the-counter drugs serve a purpose, but side effects such as dizziness, disorientation and sleepiness could cause people to stumble and fall (14). As well, seniors who take multiple medications are at higher risk of health complications from drug interactions.

A medication review with your doctor or pharmacist helps to assess the benefits and risks of prescribed drugs and may result in some drugs being “deprescribed.” This means backing off when doses are too high or stopping medications that are no longer needed (15).

4. Consider seeing a podiatrist

Be it issues with your shoes or feet, being mindful of your foot health is an important part of the falls prevention process. Podiatry care, specifically multicomponent care (e.g., podiatrist care with advice, information, exercises, and footwear and/or orthotics) and multifaceted care (e.g., risk assessment by a diverse team of professionals and a referral to a podiatrist) may reduce falls in older adults (16).

Failure (to move) is not an option!

Many older adults believe the best way to protect themselves from falling and getting hurt is by stopping some or all of their physical activities. That might seem like a safe and sensible solution but it’s flawed for a few reasons. The less you move and exercise, the weaker and more frail you become, which increases your risk of falling. And life can end up being pretty dull for people who don’t get out much.

Instead, examine your exercise and other lifestyle routines and make some changes if necessary. It’s never too late – or too early – to work on making yourself more sure-footed and able to resist falls so you can get out and about with confidence.

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  1. Canadian Institute for Health Information. Falls and vehicle collisions top causes of injury hospitalizations for seniors. [Internet] 2019. [cited June 2020]. Available from https://www.cihi.ca/en/falls-and-vehicle-collisions-top-causes-of-injury-hospitalizations-for-seniors  
  2. Public Health Agency of Canada. Seniors’ falls in Canada: Second report. [Internet] 2014. [cited May 2, 2017]. Available from https://www.canada.ca/en/public-health/services/health-promotion/aging-seniors/publications/publications-general-public/seniors-falls-canada-second-report.html
  3. Raymond MJ, Bramley-Tzerefos RE, Jeffs KJ, et al. Systematic review of high-intensity progressive resistance strength training of the lower limb compared with other intensities of strength training in older adults. Arch Phys Med Rehabil. 2013; 94(8):1458-1472. doi: 10.1016/j.apmr.2013.02.022.
  4. Waller B, Ogonowska-Slodownik A, Vitor M, et al. The effect of aquatic exercise on physical functioning in the older adult: A systematic review with meta-analysis. Age and Ageing. 2016; 45:594-602.
  5. Martins WR, de Oliveira RJ, Carvalho RS, et al. Elastic resistance training to increase muscle strength in elderly: A systematic review with meta-analysis. Arch Gerontol Geriatr. 2013; 57(1):8-15.
  6. Grossman DC, Curry SJ, Owens DK, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA. 2018; 319:1696-1704. doi: 10.1001/jama.2018.3097.
  7. Tricco AC, Thomas SM, Veroniki AA, et al. Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis. JAMA. 2017; 318(17):1687-1699. doi: 10.1001/jama.2017.15006. 
  8. Lee SH, Kim HS. Exercise interventions for preventing falls among older people in care facilities: A meta-analysis. Worldviews Evid Based Nurs. 2017; 14(1): 74-80. doi: 10.1111/wvn.12193.  
  9. Silva R, Eslick G, Duque G. Exercise for falls and fracture prevention in long term care facilities: A systematic review and meta-analysis. J Am Med Dir Assoc. 2013; 14(9):685-689. doi: 10.1016/j.jamda.2013.05.015. 
  10. Moreno-Segura N, Igual-Camacho C, Ballester-Gil Y, et al. The effects of the pilates training method on balance and falls of older adults: A systematic review and meta-analysis of randomized controlled trials. J Aging Phys Act. 2018; 26(2):327-344. doi: 10.1123/japa.2017-0078. 
  11. Laufer Y, Dar G, Kodesh E. Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review. Clin Interv Aging. 2014; 9:1803-1813.
  12. Taylor LM, Kerse N, Frakking T, et al. Active video games for improving physical performance measures in older people: A meta-analysis. J Geriatr Phys Ther. 2018; 41(2):108-123. doi: 10.1519/JPT.0000000000000078.
  13. Mat S, Tan MP, Kamaruzzaman SB, et al. Physical therapies for improving balance and reducing falls risk in osteoarthritis of the knee: A systematic review. Age Aging. 2015; 44:16-24.
  14. Woolcott JC, Richardson KJ, Wiens MO, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009; 169:1952-1960. 
  15. Page AT, Clifford RM, Potter K, et al. The feasibility and effect of deprescribing in older adults on mortality and health: A systematic review. Br J Clin Pharmacol. 2016; 82(3):583-623: doi: 10.1111/bcp.12975.
  16. Wylie G, Torrens C, Campbell P, et al. Podiatry interventions to prevent falls in older people: A systematic review and meta-analysis. Age Ageing. 2019; 48(3):327-336. doi: 10.1093/ageing/afy189.

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.