Can you predict a fall?

Created date

March 23rd, 2020
A woman holds onto the arm of a man who is climbing the stairs.

If you are 65 years of age or older, your fall risk is already high. Heed the warning signs.

The Centers for Disease Control and Prevention statistics show that, each year, more than one out of four older people fall. About three million seniors end up in emergency rooms every year with injuries from falls, and about 20% of these are serious injuries, fractures, and head trauma. 

“Falling in seniors sets off a cascade of complications,” says Beth Heydemann, R.N., M.S., A.N.P.-B.C., nurse practitioner and associate professor in the College of Nursing and Public Health at Adelphi University in Garden City, N.Y. “You might end up in the hospital, have surgery, and then face a long rehabilitation. It can be hard to bounce back from that.”

Despite these facts, some seniors do not seem to take the possibility of a fall seriously enough, as evidenced by the fact that fewer than half of those who fall every year tell their doctor about it.

If you are over 65 years of age, your fall risk is already high. But research shows there are certain signs that might indicate your risk is going up.

Warning sign no. 1: Muscle and joint problems

Muscle weakness is a warning sign but something you are unlikely to think about because it typically comes on so gradually. “Weakness in thigh and leg muscles can be especially dangerous,” Heydemann says. “You may notice it is becoming more of an effort to get out of a chair or walk up steps.”

Joint problems can cause the same type of difficulties getting around. Osteoarthritis, which is very common, doesn’t develop overnight, so the joint stiffness in your knees, hips, and ankles associated with the disease comes on gradually and may not seem unusual to you. 

“You need to pay attention to how you are walking and getting around,” Heydemann says. “Any small changes should be reported to your health care provider.”

Warning sign no. 2: Pain

Pain can be a fact of life in later years, whether it is chronic pain from a disease process or pain that comes with an injury or surgery. “Pain in your legs will of course affect the stability of your gait, but pain anywhere in your body puts you at an increased risk of falls,” Heydemann says. 

This is because even if you are somewhat accustomed to the pain, it can still cause distractions. “Pain takes your focus, or at least part of your focus, away from your environment,” Heydemann explains. “It’s just the way the brain works. You are less likely to notice tripping hazards or other things around you if you are feeling pain.”

Warning sign no. 3: Changes in hearing and vision

It is easy to understand why vision changes can make you likely to fall. But, as with other age-related conditions, sometimes these changes are gradual. “Cataracts, which cause clouding of the lens, are very common, but they develop slowly,” Heydemann says.  “You may not be aware of vision changes until they are quite advanced. This is one reason having regular eye examinations is so important.”

When it comes to hearing, studies show that even a mild degree of hearing loss triples your risk of an accidental fall, and the risk goes up with increased hearing impairment. 

“With hearing impairment, you become less aware of your surroundings,” Heydemann explains. “This, along with other age-related inner ear problems, can make it hard to determine where your body is in relation to surrounding objects. This can throw your balance off.”

Research shows that the brain tends to redirect its resources to compensate for deficits in hearing and vision. This process is not under your control, so you unknowingly have fewer resources at your disposal to navigate your surroundings. 

Warning sign no. 4: Taking multiple medications

Even when controlling for other factors, studies show that taking multiple medications is an independent risk factor for an increased risk of falling. Side effects of medications can be one reason; interactions between medications can also be a cause. 

“Medications for high blood pressure control can cause dehydration, which can make you dizzy, lightheaded, and less alert,” Heydemann says. “They can also cause your blood pressure to drop when you are getting up from a lying or sitting position, which can cause dizziness or even a temporary loss of consciousness.” 

Some medications have side effects of drowsiness, even if they aren’t used for that purpose. Antidepressants are a common example. 

Warning sign no. 5: Foot problems

Many seniors do not realize how even a minor foot problem affects how they walk. Calluses, corns, and overgrown or ingrown toenails can all throw off your gait without you being aware of it. Even slight alterations in how you walk make you more susceptible to a fall.

Reduced sensation, numbness, or tingling is another risk factor that can be a result of diabetes, circulatory disease, or nerve problems. Wearing ill-fitting shoes is another big risk.


Insurance against falls

Know your warning signs and follow these tips to reduce your risk of falls:

• Stay physically active. 

• Have your eyes and hearing checked every year. 

• Find out about the side effects of any medicine you take. 

• Stand up (and sit up) slowly. 

• Use an assistive device if you need help feeling steady. 

• See a podiatrist for regular foot and shoe examinations.

• Tell your doctor if you have fallen, even if you weren’t hurt.

• See your primary doctor regularly.


Did you know? Falling once doubles your chances of falling again. Source: Centers for Disease Control and Prevention

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