Why are falls a particular concern for older people?

Anyone can have a fall, but falls are a major health concern for older people (those aged 65 and over). Falls are the leading cause of unintentional injury in older Australians. As our population ages and the number of older people grows, the likelihood of more falls and fall-related hospitalisations increases. Nearly 1 in 3 older Australians have experienced a fall in the past 12 months. Of these, 1 in 5 required hospitalisation. Even when falls don’t cause an injury, they often trigger a loss of confidence in an older person and lead to an ongoing fear of falling. Over time, this can lead to the person limiting their movements and reducing their activity, which further increases the risk of falling. Most falls, however, can be prevented and a person’s risk of injury can be reduced. With motivation, healthy habits and an awareness of how to reduce risk, we can all play our part in preventing older people from having a fall.

Why might older people fall?

If someone falls, it’s not necessarily because they are not concentrating or they are clumsy. Reasons why older people might have a fall include:

Changes to the body

Our bodies change gradually and over many years as part of the normal ageing process. As you get older, you may notice:
  • balance problems, such as feeling unsteady when you walk
  • weaker muscles that, for example, make it harder to lift your feet when you walk
  • poorer eyesight, meaning you don’t see quite as clearly, or have difficulty with sudden light changes or glare
  • slower reaction times
  • new health problems, such as incontinence (problems with urinating or with your bowels) or dementia

Dangers in and around the home

Nearly 2 out of 3 falls happen in and around the home. Common household hazards include:
  • poor lighting
  • unsafe footwear, such as loose slippers or narrow heels
  • slippery surfaces, such as wet or polished floors, or spills
  • trip hazards like rugs, floor mats and electrical cords
  • steps and uneven surfaces

Neglecting general health and wellbeing

Older people who don’t keep physically active or fit tend to have poorer balance and weaker muscles, which increases the likelihood of their having a fall. Not eating well and not drinking enough water can also make it difficult for them to be strong enough to move about safely.

What other risk factors are there for a fall?

Certain conditions increase the likelihood of a person falling. These include:
  • A history of previous falls — If you have fallen more than once in the past 6 months, you are more likely to fall again.
  • Low blood pressure — Older people with naturally low blood pressure may feel light-headed, dizzy or unsteady while moving.
  • Postural (orthostatic) hypotension — With this condition, blood pressure drops when someone changes position, such as going from sitting to standing. Older people with postural hypotension — whether natural or due to a medication’s side effect — are at increased risk of having a fall.
  • Incontinence — You may need to hurry to the toilet often, increasing the risk of a fall, particularly at night.
  • StrokeParkinson’s disease and arthritis — These conditions change the way you move, and make it harder to react quickly and stop yourself if you stumble.
  • Diabetes — Changes in blood sugar levels can make you feel faint. Diabetes can also affect your eyesight and reduce feeling in your feet and legs.
  • Depression — Older people with depression may take a medicine that can increase their risk of falling
  • Alzheimer’s disease and other dementia — Older persons with dementia can become less aware of their surroundings and less able to react quickly.
While osteoporosis — characterised by thin, weak bones — is not a risk factor for falls, if someone does fall, there’s a higher chance of their breaking or fracturing a bone.

When should I see my doctor?

Speak with your doctor if you’ve had a fall — even if you feel fine. Falls could signal any one of a range of health issues, including a new medical problem, a side effect of your medications, balance problems or muscle weakness . Your doctor can suggest ways to reduce your chance of falling in the future. It’s also a good idea to see your doctor for regular check-ups. This helps to ensure any concerns you might have are addressed before they contribute to a more serious fall in the future.

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Last reviewed: July 2020