We shouldn't accept falls as a normal part of getting older. It's true that as we age our chances of having a fall increase, but falls are caused by a number of risk factors that can affect a person of any age.
What is a risk factor?
A risk factor is something that increases your chances of developing a problem, disease or injury. Risk factors relating to your health and wellbeing, activities and surroundings can contribute to a fall.
Although hazards within the home often contribute to a fall, more often than not falls are caused by personal risk factors.
Risk factors for falls
Falls are usually caused by an interaction of a number of risk factors. The more risk factors you have, the greater your risk of falling. Falls prevention is about recognising, and where possible, taking action to reduce the risk.
If you experience any, or a combination, of the following you could be at an increased risk:
- weak muscles, especially in the legs
- poor balance, causing unsteadiness on your feet
- dizziness or lightheadedness
- black outs, fainting or loss of consciousness
- foot problems – including pain and deformities
- memory loss, confusion or difficulties with thinking or problem solving
- vision and hearing problems
- taking medication that makes you dizzy or drowsy
- drinking too much alcohol, especially with medication
- some bladder or bowel conditions
Our muscles gradually get weaker as we get older, affecting our strength and balance and making it more difficult to undertake daily activities.
As well as normal changes caused by ageing, there are a number of reasons why our muscles get weaker, including:
A number of things can cause poor balance, including:
Dizziness can also affect balance.
Find out how to improve your balance and muscle strength
Dizziness or lightheadedness
There are a number of reasons why someone might be dizzy or lightheaded. It's not normally a sign of anything serious, but should be checked out by a doctor.
Understanding why you become dizzy is important to countering the risk. Some of the most common causes include:
- postural hypotension (orthostatic hypotension) – a drop in blood pressure when getting up from lying or sitting. This can be caused by dehydration, ageing circulation, medical conditions such as Parkinson's disease and heart conditions and some medications used to treat high blood pressure
- inner ear problems – such as labyrinthitis or benign paroxysmal positional vertigo (BPPV)
- problems with your heart rate or rhythm
Black outs, fainting or loss of consciousness
If you're prone to black outs, fainting or losing consciousness, you're at a high risk of having a fall. Loss of consciousness can be caused by a number of things, including problems with your heart rate and rhythm caused by conditions like:
- bradycardia (slow heart rate)
- tachycardia (rapid heart rate)
- atrial fibrillation (irregular heart rate)
Always speak to your GP if you've experienced a black out, loss of consciousness or have found yourself on the floor and don’t know why or how. Many of these conditions can be treated successfully.
Read more about fainting
Problems with our feet – such as corns, calluses, bunions, ingrown or thick nails and ulcerations – and footwear that is poorly fitted and inappropriate for the occasion, can also increase a person's risk of falling.
Foot problems can also make it more difficult to exercise and keep active, which is especially important if you're already unsteady on your feet because of weak muscles or poor balance.
Numbness in the feet, sometimes linked to diabetes, can leave you unable to fully sense where your foot is on the floor, leading to an increased risk of a fall.
Read more about looking after your feet
Memory loss, confusion or difficulties with thinking or problem solving
As we get older, problems with memory loss, confusion, difficulties with thinking and problem solving, can become more common. This can affect your ability to judge risky situations, take precautions when moving around your home and recognise hazards, leading to an increased risk of falls.
Vision and hearing problems
Problems with your vision and hearing can make it more difficult to move around safely. Eye problems can make it difficult to anticipate and spot slip or trip hazards in your home.
As we get older, changes to our depth perception and ability to adjust to changes in lighting can also contribute to the risk of falls. If you wear bifocal or varifocal lenses in your glasses, you might sometimes find it difficult going down steps, stairs and kerbs.
Cataracts, glaucoma and vision-related problems linked to stroke or dementia can also increase your risk of falling.
Read more about looking after your vision and hearing
The side effects of some medicines – such as dizziness, lightheadedness, unsteadiness, drowsiness, blurred or double vision and difficulty thinking clearly, and taking more than 4 medicines at the same time, can increase your chance of falling.
Medications that most commonly cause these symptoms include:
- psychotropics (tablets to treat low mood)
- blood pressure lowering medications
- sleeping tablets and sedatives
- anticonvulsants (medication for epilepsy)
Side effects can vary from person to person depending on their age, weight, gender, ethnicity and general health, so it's important that you know and understand how your medication affects you to prevent falls occurring.
Learn more about managing your medication
Drinking too much alcohol, especially with some medications, can make you unsteady on your feet and slow your reactions. As we get older, our bodies find it more difficult to process alcohol and we can become more sensitive to its effects, causing an increased risk of falls.
How much alcohol should you be drinking?
Bladder and bowel conditions
If you have a bladder or bowel condition that causes you to rush to the toilet, or visit more often during the day or night, you could be at an increased risk of falling. This is especially the case if you're already unsteady on your feet or feel dizzy when getting up from sitting or lying down.
Continence problems, and the symptoms of bladder irritability, can often be improved with the correct treatment.
A fall as a warning sign
A fall might be the first sign of a new or worsening health condition. New, and often temporary, health conditions that can cause falls include:
- infection — including a bladder, urinary tract or chest infection
- sudden confusion (sometimes called delirium)
For this reason, you should always speak to your GP practice, or other health professional – such as a physiotherapist or occupational therapist – if you've had a fall.