Falls and Balance Problems
Falls are common but often preventable. Causes, what to do if you fall, and what Cochrane and public-health sources say about exercise, home safety, medicines, vision and vitamin D.
Content last updated . This page has not been medically reviewed.
Why falls matter
More than one in four people age 65 or older fall each year, and the risk of falling and of fall-related problems rises with age. [1] A broken bone after a fall can be the start of more serious health problems and long-term disability. [1] The good news is that many falls can be prevented. [1]Fear of falling is also common. NIA notes that this fear can lead people to avoid walking, shopping or social activities, while staying active actually helps prevent falls. [1]
Common causes
Sources list several, and most people have more than one:- Weaker muscles with age, conditions that affect balance or mobility (such as arthritis, stroke or Parkinson's disease), low blood pressure, side effects of some medicines, eyesight or hearing problems, and dementia. [2]
- Blood pressure that drops too much on standing (postural hypotension), foot pain and unsafe footwear, incontinence that causes rushed trips to the bathroom, and hazards at home. [1]
- NIA adds that the more medications you take, the more likely you are to fall. [1]
What the research shows
Evidence labels: established recommendation, promising but limited, mixed, insufficient evidence.| Approach | What the source found | Strength of evidence |
|---|---|---|
| Group and home-based exercise | Reduced the rate of falls and the risk of falling. [3] | Established (Cochrane review) |
| Tai Chi | Reduced the risk of falling. [3] | Established, from the same review |
| Home safety interventions | Reduced the rate of falls and risk of falling. [3] | Established |
| Multifactorial assessment (a team checks many risk factors) | Reduced the rate of falls but not the risk of falling. [3] | Mixed |
| First-eye cataract surgery (women) | Reduced the rate of falls in one trial; second-eye surgery did not. [3] | Limited (one trial) |
| Gradual withdrawal of psychotropic medicine | Reduced the rate of falls in one trial. This is a decision for a prescriber, never to be done alone. [3] | Limited (one trial) |
| Education alone | Did not significantly reduce falls. [3] | Not supported by trials in the review |
| Vitamin D supplements | The Cochrane review said vitamin D does not appear to reduce falls overall but may help people with low levels. [3] In the 25,871-person VITAL trial, 2,000 IU a day of vitamin D3 did not reduce falls in generally healthy adults not selected for low vitamin D. [4] | Mixed to negative for people with normal levels |
Practical steps from public sources
NHS and NIA guidance includes: stay active; do strength and balance activities; wear well-fitting shoes with good grip; use non-slip mats; consider grab rails; keep floors free of clutter; get eyes and hearing checked; stand up slowly; limit alcohol; and ask a GP or pharmacist whether your medicines could affect balance. [2] [1]NHS balance routines (sideways walking, heel-to-toe walk, one-leg stand and others) are described as gentle; it suggests doing them near a wall or stable chair, building up slowly and doing them at least twice a week. [5] More on movement is in strength training and protein for older adults.
If you fall
NHS advice: stay calm, take a couple of minutes to check for pain or injury, and get up slowly only if you feel able. If you cannot get up, use a phone or alarm, keep warm and try to change position about every 30 minutes. [2]Get emergency help (use your local emergency number) if you or someone else has fallen and may have injured the head, back, neck or hip, or cannot get up. [2] Tell your doctor about any fall, even if you did not feel pain. [1]
Related topics
Sarcopenia and muscle loss · Hearing and vision changes · Osteoporosis and bone health · Multiple medicines · Natural Remedy Safety: older adultsWhen to get help
See a doctor if you have fallen, feel unsteady, or are worried about balance or mobility. A falls assessment may check strength, bones, eyesight and medicines. [2]Frequently asked questions
Can exercise really prevent falls?
In a Cochrane review, group and home-based exercise programs reduced both the rate of falls and the risk of falling. [3]
Should I take vitamin D to prevent falls?
In generally healthy adults not selected for low vitamin D, a large randomized trial found no reduction in falls. [4] Ask your provider if you might be deficient. See vitamin C, vitamin D and zinc.
Can my medicines cause falls?
Some can, through dizziness or confusion, and the risk rises with the number of medicines. Do not stop any prescribed medicine yourself; ask your doctor or pharmacist for a review. [1]
What if I am afraid of falling?
NIA says not to let fear keep you from being active, because staying active helps prevent falls. [1]
References
- National Institute on Aging. Falls and fractures in older adults: causes and prevention. Read 2026-10-22.
- NHS. Falls. Read 2026-10-22.
- Gillespie LD, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012. Read 2026-10-22.
- VITAL: Effects of vitamin D supplements on risk of falls in the US population. J Clin Endocrinol Metab. 2020. Read 2026-10-22.
- NHS. Balance exercises. Read 2026-10-22.