Losing your balance can be an unsettling experience. If you fall, it can be dangerous as well. Falls are not just risky, but common. According to the National Institute on Aging, more than one in four people 65 and older fall each year. Worldwide, the World Health Organization describes falling as a “major public health problem.” And according to the Global Burden of Disease Study, global fall prevalence among older adults increased by 182% between 1990 and 2021. Researchers project this rise to continue.
While falls can be concerning, they are not inevitable. Staying active, removing clutter, keeping conditions like diabetes and heart disease in check, and regular hearing and vision screenings can help to prevent falls. Also, things to aid with balance such as guiderails, bars, canes or walkers can help maintain or improve someone’s balance over time, thus reducing the likelihood that they fall or experience a serious injury.
Katharine Forth, the CEO of the stability scale company Zibrio, encourages older adults to regularly assess their balance to optimize their stability. She discourages people from viewing balance as a stagnant, fixed setting or from assuming that balance always deteriorates with age.
“Your balance can change every day; it can change throughout the day,” says Forth, who holds a PhD in motor control. “There’s no pill for poor balance, but there’s plenty that we can do to try and improve it.
By assessing your current fall risk and prioritizing your physical or cognitive health to maintain or improve your balance, you may be able to reduce your risk for falls at any age. Below, explore how you can prevent falls and fall-related injuries.
[Read: Best At-Home Chair Exercises and Balance Exercises for Older Adults]
What Are the Most Effective Fall Prevention Strategies for Seniors?
Preventing falls in older adults is best approached with a combination of strategies:
— Balance-focused exercises, such as tai chi or the Otago exercise program
— Physical therapy is improve strength and balance
— Clinical screenings for vision and hearing
— Fall risk assessment conducted by your health care provider
— Medication review to assess whether deprescribing medications is necessary
— Home modifications to reduce fall hazards, such as improved lighting, grab bars and removing clutter
— Treating health conditions that affect balance, such as inner ear issues that can cause vertigo and dizziness
Fall risk factors and prevention strategies
Undergo a thorough fall-risk assessment
A comprehensive fall-risk assessment may reduce your chances of experiencing a dangerous fall. The CDC’s Stopping Elderly Accidents, Deaths & Injuries Initiative (STEADI), for example, provides a framework for a comprehensive assessment of fall risk that may be implemented by your health care provider. STEADI also provides lessons on preventing falls for patients and caregivers.
Dr. Esiquio Casillas, senior vice president and chief clinical and operations officer for the AltaMed Health Services Program of All-Inclusive Care for the Elderly (PACE) in the Los Angeles area, highlights the importance of assessing modifiable risk factors for falls. These assessments, particularly when conducted in a patient’s home or living environment, are crucial for keeping patients safe, he says. He adds that interdisciplinary team members at the PACE program help conduct a formal fall risk assessment for patients, including, but not limited to, looking for vision deficits and checking for addressable obstacles and trip hazards in the home.
[READ: How to Test Whether You’re Aging Well]
Do exercises for balance and strength
Regular exercise, especially exercise that improves your strength, flexibility and balance, can keep your body fit and agile so that you’re more capable of balancing. This may help you avoid falls altogether, or enable you to catch yourself when you begin to stagger.
“Keeping active and regularly exercising muscle groups that are important in walking, bending and balance can help avoid future falls,” Casillas confirms.
The CDC recommends older adults exercise for 150 minutes a week using moderate-intensity exercises, like brisk walking, or 75 minutes a week of more intense exercise, such as jogging or hiking. The CDC also recommends devoting two days a week to strengthening muscles.
Regular exercise can also help you prevent muscle disuse, which can lead to weakness and instability. Older adults who drastically reduce their physical activity can be prone to disuse issues, as their body adapts to a more sedentary lifestyle, Forth says.
“The less movement you’re doing, the more your body’s going to adapt to sitting down,” Forth adds. “Sitting down doesn’t help you to handle gravity when you’re standing.”
In addition to your overall exercise routine, Forth recommends practicing foot-specific movements to support your balancing capabilities. These can include simple exercises like sitting down and spreading your toes wide a few times before going for a walk, she says.
“Waking the feet up a little bit and wiggling those toes around can be very helpful,” she adds.
Casillas adds that “maintaining strength in activities of daily living is one of the key pieces to keeping people independent.”
You can gain strength, balance and posture skills through initiatives like physical therapy or exercise programs like the Otago exercise program.
Physical therapy
Some people use physical therapy to gain or maintain balance.
Dr. William Buxton, a board-certified neurologist and the director of neuromuscular and neurodiagnostic medicine and of fall prevention at Pacific Neuroscience Institute in Santa Monica, California, explains that a physical therapy routine for good balance often prioritizes leg and core strengthening exercises. Core strengthening can be crucial in relieving tension on other parts of the body, like nerve pressure in the legs or bone spurs in the back, that can impact overall health and fall risks.
The Otago exercise program
The Otago exercise program (OEP) is an evidence-based exercise program for preventing falls among older adults. OEP consists of strength training, balance training and walking. A 2025 study found the OEP can effectively improve balance, gait and lower limb strength in older adults, noting greater improvements in people with compromised health.
OEP is designed to be a low-barrier program for people of various fitness and mobility levels. It consists of 17 exercises and a walking program and is designed to be practiced three times a week. The 17 exercises include five strength and 12 balance movements, the specifics of which can be modified based on your needs and capabilities. Typically, you will start OEP under the guidance of a physical therapist who will tailor the exercises to your needs.
Manage medications that increase fall risk
Have an open conversation with your doctor about your medication usage, including prescription, over the counter medications and supplements can helpful. Discuss whether deprescribing medications is necessary. If your doctor feels that the types of, or number of medications you are using are increasing your risk of falling, they may be able to adjust your prescriptions or offer advice for how to keep yourself safe while continuing to receive your medicine.
Vision and hearing impacts
Your vision and hearing status can greatly impact your balance. When it comes to vision, your eyes do more than just look out for tripping hazards. Your peripheral vision, depth perception and contrast sensitivity combine to help you distinguish objects from backgrounds and anticipate changes in your environment. Age-related vision problems can increase your risk of a fall.
A 2025 study in JMIR Aging found that distance vision impairment, near vision impairment and glaucoma are associated with a higher risk of falls in older adults.
When it comes to hearing, your hearing and balance systems share close anatomical proximity in the inner ear — and research suggests that hearing loss can affect stability. A 2025 meta-analysis in JAMA Otolaryngology–Head & Neck Surgery
, which analyzed more than 5 million participants across 27 studies, found that people with hearing loss were 17% more likely to fall over time compared to people without hearing loss.
[READ: Strength Training vs. Cardio for Healthy Aging]
7-Point Home Safety Checklist to Prevent Falls
In addition to taking care of your body, modifying your home can help reduce your risk of falling.
Some ways you can fall-proof your home include taking steps to:
1. Clear pathways and remove trip hazards
2. Bathroom safety: Grab bars and non-slip mats
3. Lighting solutions for nighttime navigation
4. Put daily items in easy-to-reach places
5. Wear a fall-detection device
6. Have a plan for travel
7. Wear sensible, non-slip shoes
1. Clear pathways and remove trip hazards
Tidying and decluttering are key to keeping a safe living environment. Going through your home, and removing and donating unnecessary items such as decorative furniture or throw rugs, can decrease your risk of tripping.
“At times we save things that have sentimental value or gather items to give to loved ones,” Casillas says. “Other times we’ve become so used to having these items that we don’t even notice the clutter around our home.”
Removing potential falling hazards in your home not only lowers your risk of falls, but it also makes it easier to navigate throughout your space if you need to use a walking assistance device like a cane or walker.
Key things to clear include:
— Extension cords and wires
— Boxes and stacks of mail or papers
— Any item that can obstruct your walkways
— Throw rugs: If they can’t be removed, firmly secure the rugs to the floor with a non-slip backing. Unsecured carpets are one of the leading causes of injury in adults 65 and older
— Pet accessories
— Laundry
— Shoes
2. Bathroom safety: Grab bars and non-slip mats
Preventing falls in the home isn’t solely dependent on removing items — adding helps too. Bathrooms can pose many hazards, and are common places for fall-risks. To help lower the chances of falling and improve senior safety, consider adding adaptive equipment, like handrails, to provide you with support around the home if you start to lose your balance.
Casillas highly recommends adding adaptive equipment to the bathroom, which is one of the most common rooms for falls.
Adaptive bathroom equipment items can include:
— Grab bars. Install grab bars near the toilet and in the shower, as relying on towel racks can be dangerous.
— Raised toilet seats. This helps to make sitting and standing easier for seniors with limited mobility.
— Non-slip mats. Make sure the tub, shower and bathroom floor have high-traction, non-slip surfaces.
— Shower chairs. Ideal for seniors who have dizziness or fatigue from bathing, these provide stability and safety.
3. Lighting solutions for nighttime navigation
Not being able to see where you’re going is a primary contributor to nighttime falling. If you can see where you’re headed, you’re less likely to fall or lose your footing.
— Install night lights. Place motion-sensitive night lights in bedrooms, bathrooms, hallways and other areas where you walk in the dark.
— Easy-access switches. Have an easy-to-reach lamp close to your bed, or motion-activated lighting that automatically turns on when you enter a room.
4. Put daily items in easy-to-reach places
Standing on ladders or reaching too far can lead to a person losing their balance. For everyday items like dishes, medications and food, try to keep those at waist or counter level.
— Avoid ladders and stools. Do not use a table, chair or other furniture to try to reach for something.
— Use a reacher tool. Try using a long-handled grabbing device for items that are not within reach, or ask someone to help you get the object.
5. Wear a fall detection device
Fall detection devices are ideal for seniors living alone. These devices can help provide peace of mind for both the individual and loved ones. They can also be set up to alert caregivers and emergency services.
— Wearable technology: There are a variety of wearables, such as the most current versions of the Apple Watch, with built-in fall detection and the ability to automatically alert emergency services.
— Medical alerts: For an added level of security, alerts for things like blood sugar, heart rate and other key metrics can be set up to provide loved ones and medical staff with updates on health changes.
6. Have a plan for travel
Reducing your risk of a fall goes beyond your own home. Fall-proofing is also important when you’re traveling, as unfamiliar environments can pose higher risks.
— Ask friends and family you’re visiting to turn on bright lights before you arrive and to clear walkways to avoid falling.
— Pay extra attention to new environments like hotels and museums, where layouts and flooring may be different than what you are used to.
7. Wear sensible, non-slip shoes
Wearing footwear that is fall-averse is essential in avoiding unnecessary slips and falls. Avoid walking in high heels, floppy slippers and slick-soled shoes, as well as walking in just socks.
— Top sensible shoe choice: Non-skid flat shoes that fit properly and are securely fastened to your foot. These should be worn both inside and outside your home.
[Read: How Clutter Affects Mental Health and Tips to Declutter]
What Causes Falls in Older Adults?
Anyone can slip and fall, but over time, health changes and challenges may increase your risk for falling.
Casillas adds that “aging affects our muscle strength and flexibility, making it more challenging to maintain balance and stability.”
“Older adults are also more likely to have chronic conditions that can affect their mobility, coordination and overall stability,” Casillas continues. “Plus, age-related vision changes and hearing loss can make it harder to navigate and identify potential hazards.”
Certain medical areas that may increase your fall risk include:
— Brain and heart health
— Vitamin levels
— Medication use
— Alcohol consumption
— Unexplained or unavoidable risks
Brain and heart health
Conditions like diabetes
and prediabetes can impact the heart and brain, leading to nerve damage impacting balance in some people. Supporting a healthy brain and heart, which can include managing blood sugar levels and treating diabetes, can support your balance.
Vitamin levels
Healthy vitamin levels, including maintaining adequate levels of vitamin B12, can aid in balance control. Long-term deficiencies in vitamin B12
can make you particularly vulnerable to falling, as vitamin b12 deficiencies can cause nerve dysfunction in the feet.
Evaluating B12 levels is part of the routine workup for assessing balance problems, Buxton says. “It’s not something everyone needs to take, but if somebody is having problems with balance, getting B12 tested can lead to an easily correctable factor,” says Buxton.
To minimize these risks, your doctor may suggest getting tested for B12 deficiency if you are struggling with your balance, or experiencing other unexplained nervous system symptoms. This could include numbness or tingling in your arms or legs, weakness or balance issues. Iron levels can also play a role, so your doctor may order a standard blood tests to check for types of anemia.
Medication use
Certain medications can alter your alertness and hurt your balance. For example, antihistamines like Benadryl can make you drowsy, hindering your brain’s response mechanisms — and reduce your ability to catch yourself when you fall. These medications can also make people sleepy during the day, increasing risks of falling asleep and falling over.
Taking multiple drugs at once, or polypharmacy, may also inhibit your balance.
“Falls often are related to side effects and drug interactions of people taking too many medications,” Casillas says. “If you are taking five or more medications, speak with your doctor to discuss the risks of polypharmacy and the option of reducing or eliminating unnecessary medications.”
Letting your doctor know about all the prescription and over-the-counter medications you’re taking can effectively help them offer you fall prevention strategies. If it’s hard to remember all your medications, consider using a pill organizer or dispenser.
Alcohol consumption
can dull your senses, leaving you less alert and less coordinated. Health professionals discourage alcohol use in many people, including older adults
“Anything more than a drink a day significantly increases risks of falls,” Buxton says.
Indirectly, alcohol contributes to damage in the nerves and feet, “which decreases the ability of our feet to give our brain feedback to know where (your) legs are in space, which can throw off balance,” Buxton says. Directly, it is a toxin to the brain, causing harm to the cerebellum, “the balance center of the brain,” he adds. Alcohol also has short-term sedative effects, which can increase your risk for falling.
While anyone can experience these negative impacts of alcohol, the National Institute on Alcohol Abuse and Alcoholism notes that older adults may be more susceptible than younger adults, as aging can lower the body’s tolerance for alcohol.
Unexplained or unavoidable and risks
While some health scenarios may make you more likely to falling than others, not all falls are avoidable.
“We can’t really eliminate the risk,” Casillas says. “It’s trying to minimize the times that they would fall or the severity of their fall. Especially if their goals of care are to remain independent, living on their own, it may not be that they can ever eliminate all falls, but certainly it could be reduced to some extent.”
Cognitive Factors and Fears That May Increase Fall Risk
Changes in brain function, such as cognitive diseases like Alzheimer’s disease and other dementias, which can develop in older adults but are not considered a natural part of aging, can increase your risks for falling. Mild cognitive impairments, lack of awareness of your health status or an internalized fear of falling may also increase your risk. Let’s explore below:
Alzheimer’s disease and dementias
Diagnoses like Alzheimer’s disease and other dementias impact memory and thinking, which can ncrease fall risks.
Mild cognitive impairments
Mild cognitive impairments can impact judgment, which can increase fall risks. These impacts may appear less extreme than those related to Alzheimer’s or dementia, but they may also be easier to dismiss. With that in mind, it is important not to ignore mild cognitive impairments and the impact they could have on you or your loved one’s fall risk.
“Mild cognitive impairment may start impairing someone’s executive functioning and ability to judge risky situations,” Casillas adds.
This could lead to someone attempting activities like climbing a steep set of stairs without holding onto a railing or, instead of using an elevator, when they could benefit from extra support.
Anosognosia
Anosognosia is a condition in which a person lacks insight into recognizing their health conditions. About 80% of people with dementia can develop anosognosia, making it a common issue and a co-factor for fall risks. Because people are unaware that they are experiencing serious cognitive diseases, they may likewise be unaware that they are at an increased risk of falling.
Dementia patients with anosognosia “wouldn’t even have awareness that they have dementia and all of these physical impairments,” Casillas says. He adds that this is concerning because, unless stopped by a doctor or loved one, they may try to engage in dangerous activities, such as driving a car, “even though their license has been taken away, because they don’t even recognize that there’s a deficit there,” in some cases.
Fear of falling
Staying vigilant about your fall risks may help you mitigate falls. But fretting about your risk too much, or letting the fear of falling consume you, can do more harm than good.
“Once someone’s fallen, they sometimes create this worsening spiral effect where they get more nervous about doing certain activities,” Casillas says. “There’s some anxiety and maybe even some depression that comes with not doing those things.”
Professionals like physical therapists (PT) or occupational therapists (OT) can work with patients to overcome their fear of falling and encourage patients to continue to partake in activities that are safe for them while they build or rebuild strength.
“A skilled OT and PT can try to help patients overcome that fear of falling and encourage people to do more of what they can do, but that is sometimes a big challenge to overcome,” Casillas says.
Social workers may also provide interventions to help people overcome these fears, Casillas adds.
[READ: Activities for Cognitive Health]
Using Technology for Fall Prevention
New technologies aren’t just for kids. Older adults can take advantage of various gadgets and wearable sensors, such as smartwatches like the Apple Watch, medical alert systems like Life Alert, passive sensors like Butlr or Amazon Alexa Together or sleep trackers like the Oura ring which can help to prevent or respond to falls.
Some technology options to consider include:
— Wearable passive sensors
— Medical alert systems
— Motion-activated lighting in hallways, bedrooms and bathrooms
[SEE: Best Fall Prevention Technology for Seniors 2026: AI & Wearables]
What to Do If You Fall
Falls can lead to serious consequences. So, if you lose your balance, it’s important to seek help.
If you fall, the National Institute on Aging recommends taking the following steps:
— Take deep breaths. This can help you relax.
— Before you get up, decide if you are hurt. Don’t get up too fast if you are hurt.
— If hurt, stay put and call for help. You can do this verbally, or through a life-alert device or smart watch if you’re wearing one. Dial a loved one on the phone if accessible, or call 911 and wait for help.
— If you are OK to move, move slowly. Roll slowly to your side, resting, then crawling on your hands and knees to a sturdy chair. When getting onto the chair, put your hands on the chair first and position your body in a kneeling position with one knee down and one foot flat on the floor, before slowly rising up to the chair.
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How to Prevent Falls in Seniors: A 7-Point Home Checklist and Expert Health Safety Tips originally appeared on usnews.com
