DoseStreaks
Health library
Growing older

Falls after 60 – why they matter, and how to prevent them

A fall is often the event that ends independent living, and most of the causes are fixable. What raises the risk, and what genuinely lowers it.

Why a fall is a bigger deal than it looks

In an older adult a fall is rarely just a bruise. A hip fracture frequently marks the end of independent living, and the loss of confidence after a fall causes people to move less, which weakens the muscles and balance that would have prevented the next one.

Falls are also treated as an inevitable part of ageing by almost everyone involved, which is why the causes so often go unexamined. Most of them are not about age at all.

The causes worth hunting for

  • Medication. The single most modifiable cause. Sedatives, sleeping tablets, some antidepressants, blood pressure medicines and water tablets all raise fall risk, and the risk climbs sharply with the number of medicines taken.
  • Blood pressure dropping on standing. Dizziness on getting up is a specific, testable, treatable thing rather than a vague symptom.
  • Eyesight — uncorrected vision, cataracts, or new bifocals, which distort where the ground appears to be.
  • Weak legs and poor balance, usually from doing less rather than from age itself.
  • Foot problems and unsuitable shoes: slippers, worn soles, backless footwear.
  • Low vitamin D, alcohol, and undiagnosed conditions such as Parkinson's or an irregular heart rhythm.
  • The home itself — see below.

The home

  1. Remove loose mats and rugs, or tape them down. These cause a large share of indoor falls.
  2. Clear walkways of cables, boxes and anything stored on the floor.
  3. Light the route from bed to toilet, and leave a light on overnight — night-time trips to the toilet are when many falls happen.
  4. Add grab rails by the toilet and in the shower or bath, and a non-slip mat.
  5. Fix uneven paving, loose steps and missing handrails outside, and keep the path clear.
  6. Keep everyday items at waist height so nothing needs a chair to reach.
  7. Keep a phone reachable from the floor, or carry one — the time spent on the floor after a fall affects the outcome as much as the fall does.

The thing that works best

Exercise that challenges balance and builds leg strength is the most effective single intervention for preventing falls — better than any supplement, and better than home modification alone.

  • Standing up from a chair without using hands, repeated a few times a day.
  • Standing on one leg while holding a counter, building up the time.
  • Heel-to-toe walking along a counter or wall.
  • Walking regularly, on varied surfaces where it is safe to do so.
  • Tai chi and similar balance-focused classes have good evidence behind them.

Consistency matters more than intensity, and the effect fades if it stops. A physiotherapist can set a programme, and it does not require a gym.

After a fall

Report every fall, even one with no injury. It is the strongest predictor of the next one, and it is what triggers a proper look for the cause.

Common questions

Should an older person use a walking stick?
It helps when it is the right height and used on the correct side, and it is a hazard when it is not. Get it fitted by a physiotherapist or clinic rather than borrowing one — a badly fitted stick makes balance worse.
Do calcium and vitamin D prevent falls?
Vitamin D helps where someone is deficient, which is worth testing for. Neither substitutes for strength and balance exercise, which is the intervention with the strongest evidence.
Is it safer to sit still and avoid the risk?
No, and this is the trap. Moving less weakens exactly the muscles and balance that prevent falls, so avoiding activity raises the risk over months. Safe, regular movement is the protective thing.

Sources

Last reviewed 4 August 2026.