Falls are usually caused by a combination of several risk factors that threaten our ability to carry out the activities of daily living safely and securely. Many risk factors affect our balance and gait (the ability to walk). In general, the risk of fall increases with the number of risk factors. These factors include physical risk factors related to your body, habits or lifestyle risk factors, and environmental risk factors.
Physical Risk Factors
As we age, many of us develop long-term physical conditions or illnesses that have an impact on gait and balance. Also, a great number of older people suffer from more than one of these conditions at the same time, making the risk of a fall even greater. The following are some examples of illnesses or conditions that increase the risk of falling:
- Older age. The risk of falling increases as we age due to declining vision, reduced sensitivity of the nerves in the feet, depth sense, and ability to adapt to the dark.
- Chronic pain
- Parkinson’s disease
- Anemia or other blood disorders
- Thyroid problems
- Foot disorders
- Muscle weakness in the legs
- Dizziness (vertigo) or balance difficulties
- Sensory disorders, such as vision or hearing problems, or numbness (neuropathy) in the legs and feet
- Brain or mood disorders, including dementia, Alzheimer’s disease, delirium, depression, or psychotic behavior.
- Urinary incontinence or having to urinate so often that it requires many urgent trips to the bathroom (sometimes too late).
- Lack of fluids in your body (dehydration). As we age we tend to lose body water. Dehydration produces low blood pressure (hypotension) which can cause falls. You can become dehydrated without realizing it if the weather is warm, if you take “water pills” (diuretics) and certain other medications, or if you have specific conditions like diabetes.
- Fear that you will fall again
Lifestyle or Behavioral Risk Factors
Even healthy people experience new challenges with aging that can increase the risk of falling.
The older you get, the more likely it is that you take many different prescription and over-the-counter medicines. When you are older, medications take longer to break down and leave your body. They may also interact with each other in ways that are unexpected and harmful. Certain medications strongly increase your chances of falling. These include medicines such as pain medications, sedatives, sleeping pills, insulin, antidepressants (depression medications), or other psychiatric medications (including antipsychotics). Additionally, diuretics and blood pressure medications can lower your blood pressure, which increases your chances of falling. Some medications have side effects such as dizziness or confusion that can also increase your fall risk. Additionally, drinking alcohol while taking medications increases the risk of a fall.
Lack of Exercise
Common problems like arthritis, dizziness, and chronic pain may make it more difficult to exercise, even if you were active before. Muscles get weaker, joints ache more, and exercise becomes increasingly challenging. Also, staying indoors reduces your exposure to sunshine. This means that your body produces less vitamin D, which you need to keep bones strong.
There may be factors in your environment that can make it more likely that you will fall. These include:
- Improper footwear. It is particularly dangerous to wear shoes with heels or shoes that your feet slide around in, or any uncomfortable footwear.
- Risks in the home. These can include loose carpets or wires, dark stairways or corridors, or water on the floor. Additionally, living in a cluttered home could cause difficulty in navigating through the home, which could lead to a trip and fall.
- Risks in the environment outside your home. These can include uneven ground, clutter in the yard, or ice and snow.
- Incorrect use of walking aids such as canes or walkers.
Last Updated August 2020