Key takeaways
- More than one in four adults aged 65 and older falls each year, according to the CDC.
- Balance and strength exercise is the best-studied way to prevent falls.
- Most falls involve several small risks at once, such as medicines, vision, footwear and hazards at home.
- A fall, or a fear of falling, is a reason to get a balance assessment, not something to accept.
Reviewed by Dr. Manan Patel, PT, DPT, TPS. Updated October 17, 2026.
Why falls happen
Falls are rarely caused by one thing. Weaker legs, slower balance reactions, inner-ear changes, vision problems, medicines that cause drowsiness or lightheadedness, numb feet and hazards at home tend to add up.1 The good news is that each one can be improved.
More than one in four older adults falls each year, and about 37 percent of those who fall report an injury that needed medical treatment or limited their activity for at least a day. Falls are also the most common cause of traumatic brain injury in older adults.2
Your home safety and balance checklist
Tick each item that is already true for you. Anything you cannot tick goes on your action list. Your answers stay on this page and are not saved or sent.
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Exercise has the strongest evidence
A Cochrane review of more than 100 trials found that exercise programs reduce the rate of falls in older adults living in the community by about a quarter. Programs built around balance and functional exercises showed the clearest benefit, and tai chi may also reduce falls.3
The programs that work are progressive and challenging: standing balance, stepping, sit-to-stand practice and leg strengthening, done regularly for months rather than weeks. World falls guidelines recommend this kind of exercise for older adults at risk of falling.1
Medicines and falls
Some medicines raise fall risk by causing drowsiness, slowed reactions or a drop in blood pressure when you stand. Common examples include sleep aids, some anxiety and depression medicines, opioid pain medicines, and some blood pressure and prostate medicines. World falls guidelines recommend a regular medicine review for older adults at risk of falling.1 Never stop a prescribed medicine on your own; ask your doctor or pharmacist whether any could be adjusted.
Building balance safely at home
Practice only with a sturdy kitchen counter in front of you and, ideally, someone nearby. Stop if you feel dizzy or unsafe.
- Sit to stand: rise from a firm chair without using your hands, if you can, and sit back down slowly. Start with 5 repetitions.
- Heel raises: rise onto your toes and lower slowly, holding the counter. Start with 10.
- Narrow stance: stand with your feet close together for 10 to 30 seconds, lightly touching the counter.
- Walking practice: a daily walk on safe, even ground, building distance gradually.
These are a starting point. A balance program designed around your test results progresses faster and more safely, which is what the research supports.
Signs it is time for a balance assessment
- You have fallen in the past year, or nearly fallen
- You feel unsteady when standing or walking
- You worry about falling, or avoid activities because of it
- You hold on to furniture or walls to get around the house
- You get dizzy when you turn your head, roll over in bed or stand up
These are the same screening questions the CDC's STEADI program asks.4
What a balance assessment includes
At North Atlanta Vertigo, a 60-minute balance evaluation can include walking and turning tests, standing balance on firm and soft surfaces, leg strength, inner-ear testing with infrared video goggles, a check for positional vertigo, and BioSway computerized balance testing. You leave with a plan built around your results, and family members are welcome at every visit.
If you do fall
- Stay calm and check yourself for injury before trying to move.
- If you are not hurt, roll onto your side, crawl to a sturdy chair and push up slowly.
- If you are hurt or cannot get up, call for help and keep warm while you wait.
- Tell your doctor about any fall, even one without injury.
Myth or fact?
Tap each statement to see what the evidence says.
Myth or fact?Falling is a normal part of aging.
Myth. Falls become more common with age, but they are not inevitable. Many risk factors can be reduced, and balance improves with training at any age.
Myth or fact?Doing less keeps me safer.
Myth. Avoiding activity weakens muscles and balance, which raises fall risk over time. Safe, guided practice is the better route.
Myth or fact?Fear of falling can raise your risk of falling.
Fact. Fear often leads to doing less, which leads to weakness and poorer balance. Addressing the fear is part of treatment.
Keep reading
- The Epley maneuver: when it works, and why the side mattersHow canalith repositioning works, why home attempts fail, and what to expect afterward.4 min read · Patients
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References
- Montero-Odasso M, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing. 2022.
- Centers for Disease Control and Prevention. Older Adult Falls: Facts and Stats. Accessed October 2026.
- Sherrington C, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2019.
- Centers for Disease Control and Prevention. STEADI: Stopping Elderly Accidents, Deaths & Injuries.
This guide is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor.
