How can I prevent falls as I get older?

What the science says now

Can exercise help prevent falls?

The U.S. Preventive Services Task Force recommends exercise programs to prevent falls in adults 65 or older who are at increased risk for falls. The most common parts were gait, balance and functional training, followed by strength and resistance training. (USPSTF)
Official recommendation for adults 65 and older at higher risk, based on intervention studies.

Does it help when a doctor brings it up?

Yes. In 22 primary care practices, a computer prompt reminded doctors to recommend exercise to patients 65 and older who screened positive for fall risk. For every 100 patients followed for a year, 19.3 had a fall at practices using the tool, compared with 21.2 at practices without it. Fall-related injuries were 15.7 versus 16.7. (A simple exercise prompt at the doctor’s office led to fewer falls in older adults · JAMA Network Open)
In people; trials.

Can an app help you feel steadier?

In England, 202 adults aged 60 and older who live at home were split by chance into two groups. Everyone got standard advice and a leaflet, and one group also used a guided balance app. After 12 weeks, the app group scored 6.35 points higher on the Berg Balance Scale, a standard balance test. (A balance app for preventing falls helped older adults feel steadier in 12 weeks · Age and Ageing)
In people; trials.

Is there a simple sign to watch?

In 7068 adults aged 60 or older in China, people whose calves shrank by 5 cm (about 2 inches) or more over three years reported a 32.5% higher chance of a fall than people whose calves did not shrink. (Your calf size over time offers a simple clue about falls · JAMA Network Open)
In people; observational.

Where can you start?

The CDC says falls don’t have to be inevitable as you age. It offers a Falls Free CheckUp questionnaire and a tool to make a customized fall prevention plan. (CDC)

What we don’t know yet

The app trial measured balance over 12 weeks, not how many falls people had. The calf study shows a link, not proof that shrinking calves cause falls. The doctor-prompt trial counted falls from medical records, so it only captures falls that reached the health system. The task force says the overall benefit of routinely offering broader, multi-part fall programs is small, so that choice should be individual. The current task force recommendation does not address vitamin D for preventing falls.

When to talk to your doctor

Talk with your doctor if you have fallen, feel unsteady, or worry about falling. Ask whether a strength and balance program or a physical therapy referral makes sense for you. The CDC also points to a resource on whether medicines can raise fall risk. Bring your medicine list, and do not change any medicine on your own.

Talk about it at dinner

Ask everyone at the table: “What is one thing that helps you feel steady?” Then try a friendly challenge after the meal. Stand next to the counter, hold on lightly, and see who can stand on one leg for 10 seconds. Cheer for every try.