15 Surprising Things That Can Increase Your Risk of Falling
Sandi Preston, a physical therapist, often reminds her 86-year-old mother to use her walker when moving about. But she forgot it one day when stepping out to get the mail. And even though it was a short distance to the mailbox, her mother lost her balance and fell.
Each year, more than 14 million adults aged 65 and older fall, according to the Centers for Disease Control and Prevention (CDC), and about 1 million of them end up hospitalized.
However, falls can be prevented. Here are 15 surprising things that can increase your risk of falling, plus advice on how to lower your risk.
Risk No. 1: Your medications
Medications can keep you healthy, but side effects that can cause dizziness, blurry vision or a delayed reaction time can make you more prone to falling.
According to the CDC, some medication categories that can increase your fall risk, include:
· Psychoactive medications, including antidepressants, opioids, and sedatives
· Antihistamines
· Muscle relaxers
· Blood pressure medications
· Anticholinergics (used to treat urinary incontinence, overactive bladder, or COPD)
Lower your risk: Keep a list of your medications — including your doses and why you are taking each. Don’t forget to include over-the-counter medications and supplements. Then, review your list with your doctor or clinical pharmacist and have them identify and discuss any that could increase your risk of falling. Your healthcare provider may make some changes, like lowering your dosage or switching to an alternative.
Risk No. 2: Diabetes
People who have diabetes often have other problems that increase the risk of falling, such as loss of vision (retinopathy) and sensory function (neuropathy). What’s more, medications that control blood sugar can cause levels to go too low (hypoglycemia), making a person light-headed.
Other Fall Risks
Several other risk factors and home hazards can lead to falls. Some of them include:
· Area rugs
· Phone chargers and other cords
· Poor lighting
· Clutter
· Poorly marked curbs and uneven sidewalks
A cane, walker, or other assistive device can help keep you more independent — and on your feet. A healthcare provider — your doctor or physical therapist, for example — can help you pick out the right device and adjust it to match your height and needs.
Lower your risk: Keep your diabetes in check by attending routine medical appointments, eating a healthy diet, keeping active most days, testing your blood sugar often, managing stress, and taking your medications as prescribed.
Risk No. 3: Other age-related diseases
Parkinson’s disease, stroke, arthritis, and peripheral artery disease can also affect your ability to walk and can increase your risk of falling.
Lower your risk: If you have one of these conditions, talk to your doctor about doing a fall-risk assessment, which includes a review of your strength, gait, cognition, and medications.
Risk No. 4: Your pets
Man’s best friend can be a fall hazard. Excited pets can jump and knock you over, Preston says. They can also get underfoot and push in front of you — especially when you’re trying to get out the door, she adds. A 2009 CDC study found that 86,629 fall injuries each year were associated with cats and dogs.
Lower your risk: If a pet is in your way, don’t step over them — make them move, the Ohio Department of Aging recommends, and always check around to see where your pet is before walking near steps. If you don’t feel you can easily handle walking your dog, hire a dog walker or ask a neighbor to help. Consider getting your pet’s energy out at a dog park or in another fenced-in area. In its 2009 report, the CDC also recommends obedience training for dogs.
Risk No. 5: Worsening memory
As we age, it’s common to have some forgetfulness — Where did I put my glasses? Developing Alzheimer’s and other forms of dementia is less common, but when it does occur, symptoms typically start after age 60.
When someone has dementia, the brain can have trouble telling the body what to do and how to navigate when walking, putting that person at increased risk of falling. A 2023 study published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, found that nearly half of older adults with dementia experienced one or more falls in 2016, compared to less than one-third of older adults without dementia.
Lower your risk: In your home, make sure that the items you need are easily and readily available. Keeping your daily routine the same can also help reduce your risk of falls. What's more, it's important to discuss any risks with your doctor. Researchers of the 2023 study call for tailored fall-prevention strategies for people with dementia.
Risk No. 6: Changes in vision
It’s not unusual for vision to worsen as you age. If left untreated, however, vision impairment can affect your balance and ability to judge distance, increasing your risk of falling.
Lower your risk: Adults 65 and older should get their eyes checked every year or two, the American Academy of Ophthalmology recommends. In addition to routine visits, “any change in vision in one or both eyes should prompt a visit to an eye doctor,” says Laura Kilty, M.D., an ophthalmologist at Bassett Medical Center in Cooperstown, New York. “It is important to be aware that since we have two eyes and use them both at the same time, one may not be aware of a vision change in one eye.”
Another key point: “A large percentage of people over 50 wear bifocals, trifocals or progressive lenses to deal with different focusing requirements,” Kilty says. But these lenses make it harder to see the ground below. If you have progressive, bifocal or trifocal lenses, drop your chin when walking downstairs or on uneven surfaces so you are looking through the upper portion of the lenses. “You may want to use glasses with a single-vision lens when walking,” Kilty says.
Risk No. 7: Postural hypotension
As you go from lying down or sitting to standing, your blood pressure drops and it can take a second or so for the blood to flow up to your brain.
But if your blood pressure drops more than normal — by 20 mmHg or more for the top number of a blood pressure reading, or by 10 mmHg or more for the bottom number — it can take longer for the blood to travel to your brain, and you may feel light-headed. This is called postural hypotension, and it’s something your doctor can test you for in the office.
Medications that affect your blood pressure can cause postural hypotension; so can dehydration, diabetes, and Parkinson’s disease, among other factors.
Lower your risk: Talk to your doctor about the possibility of changing or reducing medications that may be contributing to postural hypotension. Stay hydrated, avoid taking hot baths or showers, and try changing positions from sitting/lying down to standing slowly. Also, don’t forget to make sure you have something to hold on to.
Risk No. 8: Hearing loss
Hearing and balance are connected — both systems are in the inner ear — which is why hearing loss is often accompanied by balance problems.
Lower your risk: If you are having trouble hearing, get hearing aids — and wear them. Researchers at the University of Colorado-Anschutz surveyed adults aged 60 and older who had hearing loss, and found that even those who used their aids for just four hours a day fell less often than those who did not wear them at all.
Risk No. 9: Bunions and other foot problems
As people get older, foot abnormalities such as bunions, fallen arches and hammer toes become more common, and studies show that these issues can increase a person’s fall risk.
Lower your risk: Consider seeing an orthopedist or a podiatrist, who can prescribe orthotics (inserts for your shoes). According to the National Council on Aging, insoles can help older adults maintain their mobility and lower the risk of falling.
Risk No. 10: Muscle loss
Our muscles lose strength and bulk as we age — a condition known as sarcopenia. This varies from person to person but by age 80 or 90, some adults can lose as much as half of their muscle strength.
Lower your risk: The CDC recommends that older adults strength train at least two days a week with free weights, resistance bands, and body-weight exercises (push-ups and sit-ups) — even digging in the garden counts.
Risk No. 11: Weak bones
Not only do bones break more easily if you fall, but research shows that people with osteoporosis — an age-related condition when bones become weak and brittle — have a higher risk of falling.
Lower your risk: Incorporate weight-bearing activities into your exercise program. Also, increase your intake of calcium and vitamin D in your diet — dairy, leafy greens and fish like salmon and sardines are rich sources. There’s no need to add a supplement to your routine, unless it’s recommended by your doctor. Research reviewed by the U.S. Preventive Services Task Force has found no conclusive evidence that supplementing with calcium and vitamin D will help prevent falls and fractures.
Risk No. 12: You’re walking too slowly
You might think walking at a slower pace could help prevent falls. However, research suggests that older adults who walk slow tend to fall more often.
Lower your risk: Good footwear (be sure to shop in person and get properly fitted) and aerobic exercise (anything that gets your heart rate up) can help keep you walking at a safe pace.
Risk No. 13: Your weight
Carrying too much weight can increase your fall risk. One study published in the American Journal of Preventive Medicine even found where you carry your weight matters: Older adults who carry their weight around their middle had a higher risk of falling than those who carry their weight around their hips, researchers found.
At the same time, older adults who are underweight are at higher risk of falling than those at a normal weight.
Lower your risk: Work with your doctor to establish a healthy weight for your body type, and adjust your diet and fitness routine to reach and maintain that ideal weight. Your local Office on Aging may be able to help if you have trouble affording nutritious food.
(Read more from AARP Foundation: SNAP Benefits for Older Adults)
Risk No. 14: An abnormal heart rhythm
This can take the form of beating too fast, too slow, or irregularly, and can make you feel dizzy and light-headed.
Lower your risk: If you feel irregular heartbeats, your doctor can have you wear a heart monitor to help diagnose and treat the problem.
Risk No. 15: Having already fallen
“Falls, even those without any lasting injuries, can be emotionally traumatic to adults, jarring one's sense of confidence,” says Karin Ouchida, M.D., a geriatrician at The Center on Aging at Weill Cornell Medicine in New York City. “If any physical or psychological consequences of a fall are not addressed, a person can develop a fear of falling, which actually can increase the risk of a future fall.”
Lower your risk: If you’ve had a fall, have a fall assessment with your doctor or another health care provider, like an occupational therapist, to address the causes of your first fall, and lower your risk of another, Ouchida says.
An assessment might include:
· An initial screening to review your medical history and medications, history of falls, possible safety hazards in your home and other potential fall risks.
· Testing to evaluate balance, gait, strength, vision and hearing.
· Developing an intervention program to reduce your fall risk. You may be given a specific exercise program and referred for additional therapies and treatments.
Merle Myerson, M.D., is a cardiologist who specializes in health lifestyle and disease prevention. She is a board-certified lipid specialist and has authored many research articles and textbooks on cardiovascular disease.
http://blog.csa.us/2025/01/tech.html
By Merle Myerson, M.D., AARP
