Geriatric Fall Risk Prevention
- Physical Therapy International Service
- Feb 20
- 5 min read
Authors: Anna Norton, Ella Bonner, and Livi Kovach
Falls are oftentimes more seen in the population of older adults and can be a major burden for multiple reasons. First, they can interfere with the independence of an older individual. They also may create economic struggles with the individual if they get placed out of work or do not have good health coverage for their medical bills. Falling is more of an issue in older adults than in those younger because of the health of their bodies. As we age, we lose bone and muscle mass which is why falling can be more traumatic at an older age. Other functions in our body are also beginning to decline such as our physical senses, reflexes, and cognitive functions, leading to an increased risk for falling.
Falls can leave an immediate impact on the individual in multiple ways. Because older individuals have lower bone and muscle mass, it can be harder to physically recover from the injury. Other than physical impact, falling can have an extreme emotional one too. A common emotional response is to have what is known as “post-fall syndrome.” This is where the person is scared of moving around again because of the fear of falling.
Something beneficial to the risk of falling is that most falls are preventable. One thing we can be doing today is beginning to work on strength training. We can increase the amount of bone density and muscle mass by increasing the number of times a week that we work on strengthening exercises. This in turn, will lead to a smaller impact of fall hopefully decreasing the chance of impact of being as extreme. Many factors go into falls and many of them are external factors that can be avoided. These include slippery shoes or floors, lack of physical support objects, poor lighting, walking while distracted, medications, curbs or steps, household obstacles, or walking at too quickly of a speed. While many factors go into a fall and can change the amount of impact it has, there are various ways in which we can all decrease the risk of falls in older adults.
The purpose of a fall risk assessment is to see the risk you have at falling. Depending on the quality of risk, professionals are then able to provide strategies and resources to decrease that risk.
The Berg balance scale was created to score the balance of older adults. It goes through fourteen different tests that score them based on the time, quality of movement, and if they receive assistance with standing up. Some of the tests include sit to stand, standing with eyes closed, and reaching forward with arms stretched in front of you as you’re standing, just to name a few. The TUG test is a “timed-up-and-go” test where you start sitting, get up out of the chair, walk around ten feet, and sit back down. The time it takes for you to complete the task assesses whether or not your risk of falling is high or not. The chair stand up test is where you sit in a chair with your arms crossed at your chest and take thirty seconds to stand up and sit back down without using your hands as support. The more times you can accomplish this in thirty seconds, the lower at risk for falls you are. The final test, the gait speed test, measures how long it takes for someone to walk a certain distance. They measure both their comfortable walking speed and their maximum speed to reach the distance. This is used because a longer time is associated with loss of independent mobility.
Risk factors are conditions or situations that have been identified by research as contributors to falls. Most falls by older adults are typically caused by a combination of risk factors. Some risk factors have to do with the physical condition of a person including Vitamin D deficiency, weakness in the lower body, walking and balance issues, and vision problems. Other risk factors, such as taking certain medicines and wearing poor footwear, are external factors that can contribute to fall risk. Home hazards including broken steps or items that could easily be tripped over are factors of the environment that can increase the risk of falls for older adults. Prevention of falls can be achieved by modifying or changing any present risk factors. Healthcare providers may also conduct fall prevention interventions to further reduce the risk of falls. This may be conducted in a community or clinical setting. Overall, it is important to be aware of risk factors for falls and do your best to remove these to prevent falls.
Healthcare providers and researchers have worked to find simple strategies to help prevent falls, especially in older adults. An important step is to talk to your healthcare provider to assess your fall risk and discuss possible strategies for prevention. Your provider will be able to help you by taking into account the medications you take, any previous falls, and any health conditions. Staying active can be very effective in preventing falls, and some methods include movement on your own, water workouts, monitored exercise programs, or physical therapy. It is important to purchase and wear sensible shoes that are flat and sturdy and fit properly. You can also make adjustments to your home or living space to help prevent falls. Remove any home hazards by clearing walkways, securing rugs, and repairing any loose flooring. It is also beneficial to add more light to your home to avoid tripping over objects that may be hard to see by purchasing night lights or adding a lamp within reach of your bed. Your provider may encourage you to use a cane or walker to make your walking more steady and prevent falls. These fall prevention strategies can be very helpful if you take advantage of them as well as being conscious and aware of any fall risk factors.
Falls among older adults are common, but they should be viewed as an inevitable part of aging. Fall risk is influenced by a combination of physical, environmental, and behavioral factors that can be identified through screening and addressed through targeted interventions. Understanding individual risk through tools such as balance and mobility assessments allows healthcare providers to implement strategies that promote safety, independence, and quality of life. Additionally, recognizing risk factors such as lower body weakness, medication use, and home hazards, empowers both patients and caregivers to take preventative action.
Preventing falls requires a proactive and collaborative approach. Interdisciplinary healthcare teams, including physical therapists, occupational therapists, physicians, and other providers, play an essential role in evaluating risk, prescribing exercise or assistive devices, modifying environments, and educating patients. Evidence-based strategies such as maintaining physical activity, improving home safety, wearing appropriate footwear, and consulting healthcare professionals can significantly reduce fall risk and injury rates. Falls are a leading cause of injury in older adults, yet many are preventable through early intervention and awareness.
Ultimately, encouraging prevention-focused behaviors and promoting routine screening can help older adults remain confident, active, and independent. By shifting the perspective from reacting to falls to actively preventing them, communities and healthcare professionals can work together to support healthy aging and reduce the physical and emotional burden associated with fall-related injuries.
Resources:
Centers for Disease Control and Prevention. (2026, January 27). Facts about falls. https://www.cdc.gov/falls/data-research/facts-stats/
Mayo Clinic Staff. (2024, June 14). Fall prevention: Simple tips to prevent falls. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358
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