People tend to remember a fall as one moment: the rug, the wet step, the curb. But a fall is usually the last link in a chain. Legs a little weaker than they used to be. A slower reaction. A medicine that makes you slightly dizzy when you stand up. Dim light. Slippery slippers. Any one of those is manageable. Together they turn a stumble into a fall.
That’s the useful way to think about it, because it means you have many places to break the chain, and most of them are things you can do this week.
How common it is, and what follows
CDC reports that more than one in four adults 65 and older falls each year, but fewer than half tell their doctor. Falling once doubles the chance of falling again. Falls are the most common cause of traumatic brain injury in older adults, and they cause most hip fractures.
What gets less attention is the aftermath. After a fall, many people move less because they’re afraid of it happening again. Less movement means weaker legs and worse balance, which raises the risk of the next fall. The fear is understandable. The avoidance it creates is the part that does the damage.
Why exercise comes first
Exercise is the best-supported single thing you can do. In trials of adults living at home, it cut the rate of falls by about a quarter, and fewer people fell at all. It may also reduce falls that cause fractures or need medical care, though that evidence is less firm. The U.S. Preventive Services Task Force reached the same conclusion in 2024, recommending exercise programs for adults 65 and older at higher risk of falling.
The kind of exercise matters. Balance and functional exercises, and programs that combine balance with strength, did best. Walking, dance and strength work on their own showed unclear effects on falls. They’re still good for you, but for falls, balance work belongs in the plan on purpose. Side effects in the trials were mostly sore muscles.
Practice five minutes of supported balance
About 5 minutes · Easy. Keep a hand on the counter the whole time.
Stand beside a stable counter or chair and practice comfortable weight shifts with support within reach.
Steps
- You will need
- A stable kitchen counter or sturdy chair to hold, and a clear floor.
- Done when
- You practiced shifting your weight for a few minutes, with support in reach.
- Stand beside the counter with one hand resting on it.
- Slowly shift your weight onto one foot, then back to the middle.
- Slowly shift your weight onto the other foot.
- Keep going at a calm pace for about five minutes, resting whenever you like.
Break the rest of the chain
Exercise is the centerpiece, but CDC’s prevention advice lists several other levers. Each is small.
- Have your medicines reviewed. Ask your doctor or pharmacist whether any prescription or over-the-counter medicine, or a combination, can cause dizziness or drowsiness.
- Get your eyes checked at least once a year and keep your glasses current. If you wear bifocals or progressives, ask whether a distance-only pair for walking outside would be safer.
- Make your home safer: clear tripping hazards, add grab bars by the tub, shower and toilet, put railings on both sides of the stairs, and brighten dim areas. The Home Safety Checklist walks you through it.
- Choose shoes that fit well and hold your foot, and avoid walking in socks or loose slippers on smooth floors. This is common-sense advice, not a trial result.
- Ask about bone health. If you have osteoporosis, a fall is more likely to cause a fracture, and treatment lowers that risk.
- Ask about vitamin D. CDC suggests asking your clinician whether a supplement makes sense for you. It’s a question for them, not a substitute for exercise.
Fear of falling, and how to move past it
Being careful is fine. Being so careful that you stop doing things is where the trouble starts. If you catch yourself skipping walks, avoiding stairs or turning down outings, treat it as a signal to train, not to retreat. Strength and balance work is the direct answer to the worry: the stronger and steadier you get, the more your confidence has something real to stand on.
Start where you feel safe, at a counter, and build up slowly. Many people find the fear eases as the exercises get easier. If the fear is strong or you’ve already fallen, a physical therapist can assess you and set up a program with the right margins.
If you do fall
Take a moment before you move and check yourself for pain or injury. If you’re hurt, can’t get up, or hit your head, call for help instead of forcing yourself up. If you feel fine, roll to your side, get onto your hands and knees, and use a sturdy chair to push up slowly. Then tell your doctor, even if nothing seems wrong. A fall is useful information about what to fix.
The Fall-Risk Checklist takes about two minutes and stays in your browser. The chair stand and balance checks are self-guided versions of clinician tools, and each tells you where it stops.
Your next step
A five-minute counter routine, with a progression for when it gets easy.
Start balance practice
