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Focus On Health: Risk Factors and Prevention of Falls in Older Adults

By Dr. Christina Schoer

Did you know, falls are the leading cause of injury among older Canadians with 20-30% of seniors experiencing one or more falls per year? In turn, falls diminish function by causing injury, activity limitations, fear of falling, and loss of mobility. In general, fractures of the hip, pelvis, wrist, and arm are the most common serious injuries in older persons resulting from the combined effects of falls, osteoporosis, and other risk factors that increase susceptibility to injury.

There are various risk factors that increases an individual’s risk of falling, and these can be categorized into intrinsic and extrinsic risk factors.

Intrinsic Risk Factors

Intrinsic risk factors are internal, personal factors that increase the risk of falls. Studies have found that certain medications, medical conditions, and even an individual’s level of strength and balance can contribute to an increase in fall risk.

It is suspected that certain medications such as psychotropics, diuretics, antihypertensive, and antiparkinsonian medications, especially when inappropriately dosed or consumed, may contribute to falls by decreasing alertness, depressing motor function, and causing fatigue and dizziness. Polypharmacy, the use of five or more medications, has also been associated to increased risk of falls in older adults.

Several common medical conditions, such as arthritis, dementia, cataracts, stroke, and urinary incontinence are associated with falls as they directly impact vision, cognitive function, and balance and mobility.

Lastly, studies have found that impaired vision, lower limb sensory impairment, reduced lower limb strength, and reduced grip strength are associated with increased falls in older adults. These contributing factors play a role in maintaining proper mobility and balance, and when compromised, the risk of falls increases.

Extrinsic Risk Factors

Extrinsic risk factors are external to the individual and include hazards such as inadequate lighting, unsecured mats or rugs, lack of non-slip surfaces in showers or bathtubs, clutter, slippery floors, inappropriate indoor footwear, and lack of railings for support, among many others. Specifically, one-third to one-half of falls are caused by environmental hazards in the individual’s home.


The risk of falls among older adults can be significantly reduced by addressing present risk factors. These risk factors can be mitigated by engaging in physical activity to maintain strength and balance, ensuring proper dosage and consumption of medications, and addressing potential in-home hazards.

Evidence shows that exercise, specifically weight-bearing and balance exercises, prevents falls and injury by strengthening muscles, increasing endurance, maintaining and improving joint function and posture, improving cardiorespiratory function, and increasing alertness.

It is important to consult with your medical doctor about your current medications, specifically about proper dosing, consumption frequency, side effects of medications, and more. This will ensure you are consuming your medication safely, which may help to decrease your risk of falls.

Lastly, one can decrease their risk of falls by ensuring their home is safe and free of environmental hazards. For example, installing handrails and non-slip mats in showers and bathtubs to avoid slipping, removing clutter (especially on the floor), ensuring adequate lighting is installed, wearing supportive footwear indoors, and securing/removing rugs to avoid tripping.

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