Falls are a leading cause of injury in the elderly. With significant physical, emotional, and financial impacts on both individuals and healthcare systems, fall prevention for seniors is a priority globally. Evidence suggests that interventions like physiotherapy, regular exercise, and environment modification are key in preventing falls in the elderly.[i]
This blog explores ten concerning statistics about falls in the elderly and how these interventions can work together to change these concerning statistics in a favourable way.
Table of Contents
- Five surprising statistics about falls in the elderly
- Five unchanged statistics about falls over the last 20 years
- How physiotherapy, exercise and environment modification work together
- Final thoughts on preventing falls in the elderly
Five Surprising Statistics About Falls in the Elderly
The following statistics[ii] regarding falls in the elderly are certainly surprising due to the seriousness and repercussions falls can have on some of our most vulnerable loved ones.
- Nearly half of all falls in the elderly lead to head injuries or hip fractures. These serious injuries often result in long hospital stays and challenging recoveries, making fall prevention crucial for maintaining independence and quality of life. With age, natural declines in muscle strength and joint stability increase the difficulty of maintaining balance and responding quickly to prevent a fall. Programs focusing on strengthening exercises and safe movement techniques can help elderly individuals build the resilience needed to prevent these high-risk falls.
- Elderly individuals with mild cognitive impairment are twice as likely to fall. Cognitive impairments impact judgment and spatial awareness, which increases the risk of falls. Physiotherapy programs tailored for seniors with cognitive impairments often include targeted balance training, such as single-leg stands and multi-task exercises that improve spatial orientation and stability. These activities not only address physical weaknesses but also help compensate for cognitive challenges, empowering individuals to navigate their environments more safely.
- Falls are responsible for 80% of injury-related hospital admissions for people over 65. This statistic reflects the enormous strain falls place on healthcare systems and underscores the need for preventive measures like balance and strength training. A combination of regular physiotherapy, strength training, and environmental safety assessments can help alleviate the healthcare burden by preventing injuries that often lead to long-term hospitalizations.
- Twenty-five percent of elderly people need help with everyday activities for the first time after a fall. Many seniors maintain independence until a fall significantly reduces their mobility and function. Preventive exercises, such as lower-body strength training (e.g., leg presses or resistance bands), are particularly effective for improving functional strength and balance. Programs that focus on building strength and confidence can allow seniors to continue managing daily tasks independently, even as they age.
- Fear of falling increases the risk of future falls by 20-30%. The fear of falling itself can lead to activity avoidance, which in turn weakens strength and balance over time, making falls more likely. Regular exercise, particularly balance-focused activities like Tai Chi and walking, not only improves physical stability but also helps build confidence. Seniors who feel more capable in their physical abilities are more likely to maintain active lifestyles, reducing their fall risk over time.
Often times, clients and their families seek formal health-related services, typically in response to a number of falls that have occurred. With further investigation, clinicians may uncover that this person was experiencing near-falls prior for quite some time before experiencing actual falls in question.
Having worked in a clinical setting with clients who have sustained mild, moderate, and severe traumatic brain injuries, it makes sense that to me that those with cognitive and psychological or psycho-emotional limitations will also be at a higher risk of falls and experience them more often than those who do not. Those who uncover the root causes for their falls earlier often benefit from their individualized therapeutic intervention.
Five Unchanged Statistics About Falls Over the Last 20 Years
Although we’ve come a long way in terms of physical supports, assistive devices, technology, footwear, and safety measures in commercial and residential settings, we see that the issues contributing to falls risks are complex and multifactorial, leading to some statistic holding true and consistent for quite some time.
- Approximately 30% of people over the age of 65 fall each year worldwide. Despite advances in healthcare, this rate has remained consistent, demonstrating the need for proactive measures to reduce falls. Simple adjustments to seniors’ home environments—such as clearing pathways, using non-slip mats, and adding grab bars—can greatly reduce hazards, especially given that 40% of elderly falls occur at home.
- Falls are the second leading cause of unintentional injury-related deaths worldwide. This statistic has stayed steady, underscoring the critical need for global fall prevention initiatives. Physiotherapists can design tailored programs for seniors that improve balance and muscle tone, helping them avoid injuries that often lead to severe consequences. Exercises that target the lower body, such as squats and leg presses, can be especially effective in reducing the impact of falls.
- Fifty percent of elderly individuals who fall will do so again within a year. Repeat falls are common among seniors, emphasizing the need for ongoing prevention measures. Physiotherapy and exercise programs that build balance and leg strength can reduce the likelihood of repeat falls. Seniors who commit to these interventions often experience improved mobility and fewer fall incidents, making exercise a powerful tool in preventing repeated falls.
- Women are more likely to experience falls and fall-related injuries than men. Due to more rapid bone density loss, women are often at a higher risk of fall-related fractures. Incorporating resistance training and bone-strengthening exercises into fall prevention programs can help women maintain better stability and reduce their injury risk. Additionally, physiotherapy that focuses on joint stability can support postural control, addressing specific needs that contribute to fall prevention.
- About 40% of elderly falls happen at home. Since home remains the primary site for falls, modifications to the home environment—such as installing grab bars in bathrooms, improving lighting, and removing tripping hazards—are critical in reducing fall risks. Wearable fall-detection devices are also increasingly available and can provide added safety by automatically alerting caregivers or medical professionals in the event of a fall, allowing seniors to live independently while still receiving immediate assistance if needed.
Has population health and physical robustness decreased significantly enough in the past decades to offset our society’s extrinsic advancements? The World Health Organization describes an aging population worldwide, and most falls occurring in developing nations worldwide, although many also occur in developed nations.[iii]
A combination of an aging population, comorbidities like dementia and low-bone density, can help to explain how some of these statistics remain at the levels they are today. Although medical direction continues to keep us alive for longer, our shift in focusing on health-span and disability-free years of life should be considered a top priority as well.
Preventing falls in the elderly from happening and taking action before they begin are discussions you and your primary health care provider can be having at your annual check ins.
How Physiotherapy, Exercise, and Environment Modification Work Together
Combining physiotherapy, exercise, and environment modification creates a comprehensive fall-prevention approach that addresses both physical and environmental factors contributing to fall risk.[iv] These interventions work together as follows:
- Physiotherapy and Exercise: Physiotherapists assess individual weaknesses and provide targeted exercises, while general exercise programs keep seniors active and improve overall physical fitness.
- Moderate-Intensity Group Exercise: A study involving group-based moderate-intensity exercise program, involving strength and balance exercises for one hour, three times per week over six months, reduced falls by approximately 23%.[v]
- High-Intensity Resistance Training: Skelton et al. demonstrated that high-intensity resistance training at 70-80% of 1RM improved lower body muscle strength by up to 30%, leading to a 15% reduction in fall incidents over six months.[vi]
- Frequency and Duration: Studies by Liu-Ambrose et al. indicate that higher frequency (three or more times per week) and sustained intervention (lasting at least 12 weeks) are associated with the best fall prevention outcomes, often reducing fall rates by 20-30% relative to lower-frequency interventions.[vii]
- Physiotherapy and Environment Modification: A physiotherapist can also suggest specific environmental changes based on the senior’s mobility, ensuring that any unique physical needs are addressed.[viii]
Final Thoughts on Preventing Falls in the Elderly
Preventing falls in the elderly is vital for maintaining independence, health, and quality of life. With physiotherapy, exercise, and thoughtful modifications, seniors can significantly reduce their risk of falling and continue to lead active, fulfilling lives.[v]
Although this blog focused on falls prevention and the parameters behind improving balance in the elderly, there is something to be said about the contingency plan and the steps to recover after a fall has already happened. Falls recovery training is an integral piece to the puzzle in preventing falls in the elderly.
The Government of Canada website provides a step-by-step guide and downloadable poster on what to do in case of a fall depending on whether or not you can get up, and even as the witness of a fall incident.
Preventive measures are beneficial for both seniors and healthcare systems. By investing in fall prevention, societies worldwide can reduce healthcare costs, support the elderly, and ensure that people can age safely and independently.
It is important as physiotherapists and clinicians that we continue to strike a balance between pushing our clients to make the changes they need to make and understanding their goals. Practicing dynamic balance strategies and working on movement patterns that expose weaknesses can be additionally difficult with people who have a fear of falling or have had falls in the past.
Although client comfort and a client-centered treatment plan is necessary to establish adherence to a program, we must ensure the intensity and difficulty of the balance exercises reach a point that truly challenges the person and puts them in a position (safely) to practice balance strategies they would encounter in everyday life. Over-supporting and limiting the difficulty to increased comfort for the client may be, indeed, doing a disservice to their overall goals.
Educating clients and families around the importance of falls prevention and balance training is key to helping clients achieve their goals. Falls prevention training and strategies are an integral piece in allowing older adults to stay mobile and independent as long as possible.
References
[i] World Health Organization. “Falls.” World Health Organization.
[ii] Gillespie, L.D., et al. “Interventions for preventing falls in older people living in the community.” The Cochrane Database of Systematic Reviews, 2012.
[iii] World Health Organization. “Falls.” World Health Organization.
[iv] Moncada, L. V., & Mire, L. G. “Preventing Falls in Older Persons.” American Family Physician, 2017.
[v] Sherrington, C., Michaleff, Z. A., Fairhall, N., Paul, S. S., Tiedemann, A., Whitney, J., Lord, S. R. (2017). Exercise to prevent falls in older adults: An updated systematic review and meta-analysis. British Journal of Sports Medicine, 51(24), 1750-1758.
[vi] Skelton, D. A., Dinan, S., Campbell, M., & Rutherford, O. (2005). Tailored group exercise (Falls Management Exercise—FaME) reduces falls in community-dwelling older frequent fallers (an RCT). Age and Ageing, 34(6), 636-639.
[vii] Liu-Ambrose, T., Khan, K. M., Eng, J. J., Lord, S. R., & McKay, H. A. (2004). Balance confidence improves with resistance or agility training. Age and Ageing, 33(6), 607-612.
[viii] Lord, S. R., et al. “Falls in Older People: Risk Factors and Strategies for Prevention.” Cambridge University Press, 2007.
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