Balance and fall prevention for older adults

with advice from Maureen Gaynor, MSPT
and Nicole Puzio, PT, DPT

Balance and fall prevention for older adults

Injury and even death from falls is an unfortunate trend for older adults. According to USA Today, between 1993 and 2003, “death rates from falls rose 55% among people over age 65. Falls accounted for 13,700 deaths and landed 1.8 million older adults in emergency rooms.” As Baby Boomers approach their 70s, they need to consider how to improve their balance and reduce their chances of falling.

According to Maureen Gaynor, a physical therapist at Physiquality member Comprehensive Physical Therapy Center in Michigan, “Falls are the sixth leading cause of death in people over 65 years of age and the leading cause of death in women over 85.” She also points out that while the rates of falls are highest past the age of 85, the rates increase with age regardless of gender or ethnicity. Everyone is at risk as they age.

That said, several factors can increase one’s risk of falling. Nicole Puzio, a physical therapist at Conshohocken Physical Therapy, a Physiquality network clinic in Pennsylvania, notes that conditions like diabetes or Parkinson’s disease can contribute to one’s risk, as well as poor vision. Maureen also includes such disorders as vertigo, neuropathy, postural hypotension, osteoporosis and cognitive impairments on that list.

The Center for Disease Control suggests doing four things to prevent falls:

  1. Begin a regular exercise program.

Tai chi has been shown to improve balance.Exercise is a great way to feel stronger and healthier. If you haven’t exercised in a while, consider something low-impact: both yoga and tai chi have been shown to improve balance, strengthen the core and reduce the risk of falls. Nicole suggests strengthening the lower extremities, doing squats (while holding onto a chair for balance if needed) and simple repetitions of standing from a seated position.

Maureen points out that seniors need to make sure hips and ankles are strong, advising visiting a PT if the ankle is prone to rolling or giving way. She also notes that seniors with osteoporosis are at an increased risk for more serious injury, should they fall, and recommends that anyone diagnosed with osteoporosis use weight-bearing exercises like walking and squats to build bone density.

  1. Have your health care provider review your medicines.

Both Maureen and Nicole point out that taking four or more medications can increase the chance of falling. As you age, your body may react to medications differently, and medications can combine to create dizziness or sleepiness. Be sure to tell your doctor about everything you’re taking, including over-the-counter medications or herbal remedies, and especially if you’re seeing multiple doctors that could prescribe conflicting medications.

Have your vision checked.

  1. Have your vision checked.

As Nicole mentioned, poor vision is a big risk factor for falling. Be sure to get your eyes checked once a year, in order to update your glasses or contacts prescription, as well as get tested for such conditions as glaucoma, cataracts and macular degeneration.

  1. Make your home safer.

The simplest way to reduce the chances of an at-home fall is to tidy up. Nicole reminds seniors to remove clutter and loose cords, stabilize or throw out throw rugs, and be cautious of small pets. She also suggests wearing slippers or socks with traction and adding railings in both stairwells and near toilets and showers. (Need help evaluating your home for safety? The New York Times published a story on several businesses that help older adults make their homes safer.) Maureen also advises keeping your home well-lit, both with adequate lighting and strategically placed nightlights, to reduce nighttime accidents. Bright tape marking changes to surface levels, like a step down into a living room, can also help seniors to see where to adjust their steps.



Maureen Gaynor, MSPT, is a physical therapist at the Comprehensive Physical Therapy Center, a Physiquality network clinic with six locations throughout the Detroit/Grand Rapids area in Michigan.

Nicole Puzio, PT, DPT, is a physical therapist at Conshohocken Physical Therapy, a Physiquality network clinic in Pennsylvania.



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For further reading, look through our selection of articles on the danger of falls for seniors, in addition to the below links:

Stein, Jeannine. Yoga may help improve balance for older stroke patients. Los Angeles Times, June 4, 2011.

Stabiner, Karen. New advice on preventing falls. New York Times, February 17, 2011.

Alderman, Lesley. Making home a safer place, affordably. New York Times, July 17, 2009.

What YOU can do to prevent falls. Center for Disease Control, January 19, 2009.

Seniors falling into danger. USA Today, December 3, 2006.



The material and information contained on this Web site is for information only and is not intended to serve as medical advice or consultation.

Consult your personal physician before beginning any exercise program or self-treatment.