Causes and Risk Factors

Many Possible Causes

Falls don't "just happen," and people don't fall because they get older. Often, more than one underlying cause or risk factor is involved in a fall. A risk factor is something that increases a person's risk or susceptibility to a medical problem or disease.

As the number of risk factors rises, so does the risk of falling. Many falls are linked to a person's physical condition or a medical problem, such as a chronic disease. Other causes could be safety hazards in the person's home or community environment.

Risk Factors

  • Muscle weakness, especially in the legs, is one of the most important risk factor. Older people with weak muscles are more likely to fall than are those who maintain their muscle strength, as well as their flexibility and endurance.
  • Your balance and your gait -- how you walk -- are other key factors. Older adults who have poor balance or difficulty walking are more likely than others to fall. These problems may be linked to a lack of exercise or to a neurological cause or arthritis or other medical conditions and their treatments.
  • Blood pressure that drops too much when you get up from lying down or sitting can increase your chance of falling. This condition -- called postural hypotension -- might result from dehydration, or certain medications. It might also be linked to diabetes, neurological conditions such as Parkinson's disease, or an infection.
  • Some people with postural hypotension feel dizzy when their blood pressure drops. Other people don't feel dizzy, even if their blood pressure drops a lot when they get up.
  • Your reflexes may also be slower than when you were younger. The increased amount of time it takes you to react may make it harder to catch your balance if you start to fall.
  • Foot problems that cause painful feet, and wearing unsafe footwear can increase your chance of falling. Backless shoes and slippers, high-heeled shoes, and shoes with smooth leather soles are examples of unsafe footwear that could cause a fall.
  • Sensory problems can cause falls, too. If your senses don't work well, you might be less aware of your environment. For instance, having numbness in your feet may mean you don't sense where you are stepping or getting up at night in dim light
  • Not seeing well can also result in falls. One reason is that it may take a while for your eyes to adjust to see clearly when you move between darkness and light.
  • Other vision problems contributing to falls include poor depth perception, cataracts, and glaucoma. Wearing multi-focal glasses while walking or having poor lighting around your home can also lead to falls.
  • Confusion, even for a short while, can sometimes lead to falls. For example, if you wake up in an unfamiliar environment, you might feel unsure of where you are. If you feel confused, wait for your mind to clear or until someone comes to help you before trying to get up and walk around.
  • Some medications can increase a person's risk of falling because they cause side effects like dizziness or confusion. The health problems for which the person takes the medications may also contribute to the risk of falls.
  • The more medications you take the more likely you are to fall. People who take four or more prescription drugs have a greater risk of falling than do people who take fewer drugs. We we think your medications are causing dizziness or unsteadiness a safer alternative can be given. Do not change your medications on your ow.

About us & balance and fall

  • Our physical therapist & Doctor can check your walking and balance. They might do a "Get-Up and Go" test. This simple test shows how steady you are when you get up from a chair. The test also is used to check your walking ability. Based on the findings a customized treatment plan will be formulated.
  • We also find out about the possible side effects of medicines you take. Some medications might affect your coordination or balance, or cause dizziness, confusion, or sleepiness. Some medications don't work well together, adding to your risk of falls. So please bring your prescribed and over-the-counter medicines with you when you visit us.


  • It's important to keep muscles strong. Strengthening muscles in the lower body can improve balance. Our physical therapist will plan a physical activity program that is right for you.
  • Strength and balance exercises which will reduce your risk of falls and improve gait.
  • Tai Chi is one type of exercise that may help prevent falls by improving balance and control. This exercise uses slow, flowing movements to help people relax and coordinate the mind and body. It can also boost your self-confidence. Dancing and other rhythmic movements can help as well.
  • Mild weight-bearing exercise -- such as walking or climbing stairs -- may help slow bone loss from osteoporosis which can prevent fractures if you do fall.