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Falls are the most common cause of death in the over 65’s.

Updated: Feb 26

250,000 people are treated in hospital as the result of falls every year, out of these, around 9000 will die. The future is often bleak for older individuals who fracture their hip, with an increased risk of dying (between 18-33%) within a year of the fall. For those who do not die, there is often a negative impact on their ability to live independently, with 20% having to enter long-term care.

If like me, you have elderly friends and relatives, those statistics can be absolutely terrifying!

Most falls are multifactorial (meaning there are lots of different reasons that all coincide), such as loss of strength/balance, hearing and sight difficulties, side effects of medication, trip hazards within the home, and of course, icy weather. It is also important to note that the individual doesn’t necessarily need to be frail to fall – 1 in 3 people over 65 will have a fall in a year, with this number increasing to 50% once over 80.

How do we identify who is at risk from falls?

As we age, the risk of falling naturally increases, however a 2021 study looked at the relationship between the length of time a person could balance on one leg and future risk of falling. It was shown that risk increased significantly if the person was unable to balance on one leg for less than 10 seconds.

Another often used test is the sit to stand test. Using a sturdy chair without arm rests, the person is sat in the chair, feet shoulder width apart and arms crossed over the chest. They are then instructed to stand up and sit down as many times as possible in 30 seconds. If they have to use their arms to push themselves up then they are scored 0. For 65-69 year old's, 11-16 reps is considered adequate. For 70-79, 10-15 reps. And for 80-89, between 9-13. Any score below this is considered high risk for falling.

If you have recently had a fall, the risk of another increases. Other risk factors can include feeling weak when trying to get up from a chair or bed or a reduction in activity.

So what we can do to help reduce these risks?

1. Balance:

We rely on automatic reflexes to keep us upright when we trip or overreach for something. Unfortunately, these reflexes do slow down the older we get. However, we can improve our balance by doing simple exercises(see further down).

2. Muscle strength and joints

As we age, we naturally lose muscle mass (sarcopenia) and between the ages of 50 and 70, we lose approx. 30% of our muscle strength. The best way to prevent this is to be as active as possible.

3. Bone density:

It goes without saying that the stronger our bones are, the less likely they are to break. Bones naturally become more brittle as we age, especially in menopausal women. Resistance exercises 2/3 times a week should be encouraged. It is also important that you are getting enough calcium in your diet and you may need a vit D supplement if you are not getting much sun or have darker skin.

4. Get eyesight checked:

This is free for the over 60s. Even if you feel that your eyesight is fine, it is still worth getting it checked as aging can alter depth perception, contrast sensitivity (seeing where the edge of a kerb is) and cause visual field disturbances. The optician can also check for glaucoma, cataracts, diabetic retinopathy etc.

5. Don’t rush:

Whether it’s getting up to go to the loo at night or out shopping, take your time and look for anything in your path that you may trip over.

6. Fall proof your home:

Get rid of rugs (especially near the top of stairs) without a grip bottom, check that carpets are not frayed or starting to come up at the edges. All wires should be tucked away safely. Glass furniture can be problematic as it may be difficult to see. Ensure that everywhere is well lit and if you do need to get up in the night to go the loo, then a motion activated light will help. Keep clutter out of walkways and never put anything on the stairs!

As previously mentioned, prevention is better than cure – the stronger and more active you can stay, the better. If you do have elderly friends/relatives then encouraging them to attend Tai chi or strength/fitness classes will help. If they are reluctant to attend group classes then there are exercises they can do at home to help.

If you have any doubt over the suitability of the exercises for you condition, please speak to a medical professional before commencing!

Exercises can include:

Sit to Stand

Using a sturdy chair which will not slide, move form a sitting position to a standing. Preferably you do not want to use your arms to help with this. Repeat 10 times.

Heel raises

Use a wall or a sturdy chair to help with balance. From a standing position, rise up onto your toes before lowering yourself back down in a controlled manner. Repeat 10 times.

Single leg balance

Holding onto the back of a sturdy chair, lift one foot of the ground and hold the balance for 10+ seconds.

Heel to toe walking

Using a support such as a kitchen worktop. Place your heel in front of the toe of the opposite foot. Repeat for 10 steps. It is important that you take your time with this exercise and do not rush!

Overall, the most important message is to keep as active as possible. If you feel like your activity levels are low, then it is never too late to start exercising!

I hope you found this information helpful but it is in no way intended to replace medical advice. Should you have any concerns about yours or someone else's risk from falling, please seek the advice of a professional.


Campbell AJ, Robertson MC. (2003). Otago exercise programme to prevent falls in older adults.

Larsson et al. (2021). One leg standing time predicts fracture risk in older women independent of clinical factors and BMD.

Public Health England (2015). Get up and Go! get_up_and_go_0.pdf (



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