What older people can do to prevent falls

Photo of an older woman taking a tablet

Falls can happen at any age. But because they can have serious consequences in older people, it's worth taking measures to prevent them. Some of these measures are quite easy to do.

One simple and effective measure is to eliminate tripping hazards around your own home. Occupational therapists can help you to do this. In Germany, this help is offered as part of a special program for the prevention of falls ("Sturzpräventionsprogramm"). People living in Germany can ask their family doctor, a neurologist or occupational therapist for more information.

Various medical aids can be used too – for example, a grabber tool to pick objects up off the floor, a walking aid, a shower seat or a bath lift.

Can exercise programs help?

Research has shown that certain kinds of exercise programs can help to prevent falls in older people. These programs mainly include exercises to improve muscle strength and balance. They can be done in a group or one-to-one. The researchers looked at various forms of exercise, including

  • walking and balance training,
  • strength training,
  • dancing or tai chi, and
  • aerobic exercise.

But it's important to choose exercises that are suited to your own physical abilities.

Programs offered by a team of specialists from various fields (e.g. physical therapy and geriatric care) also help to prevent falls. Such mixed teams can recognize individual risks more easily and better adapt the measures to your personal needs.

Which medications can increase the risk of falls?

Some medications can increase the risk of falls, either when taken alone or together with other drugs. They include

  • sedatives or sleeping pills,
  • diuretics and blood-pressure-lowering drugs,
  • anti-epileptic drugs (anti-seizure drugs),
  • opioids and
  • some diabetes medications.

But you shouldn't stop taking any of these medications without consulting your doctor first. It is best to have regular doctors' appointments to talk about which medications you still need to take. It can help to put together a medication schedule to take along to your doctors' appointments. This is a list of all the medications you are on.

Can vitamin D prevent falls?

Current research suggests that older people in nursing homes and hospitals are less likely to have a fall if they take vitamin D. But only if they have low levels of vitamin D to start off with. Their vitamin D levels can be measured using a blood test.

Vitamin D is believed to strengthen muscles. It also helps the body to absorb more and phosphate from the bowel when necessary. Having enough calcium in the body is important for normal bone metabolism and, as a result, bone stability. Vitamin D might be more effective when taken together with .

Vitamin D and supplements can have side effects. These mainly include the development of kidney stones. European and U.S. authorities recommend taking not more than between 1,000 and 1,300 mg of in the form of dietary supplements a day.

What else might help?

It is also a good idea for different health professionals (such as doctors, nurses, physical therapists and occupational therapists) to jointly assess the individual risk of falling and then recommend preventive measures based on their findings. Research has found the following to be helpful:

  • Treating vision problems and, for example, using a normal pair of glasses instead of bifocals.
  • Cataract surgery (if you have cataracts).
  • Occupational therapy.
  • Treating foot problems.
  • Using footwear with slip-resistant soles or shoe inserts.

Behavioral therapy can reduce the fear of falling.

Even though you can do a lot to prevent falls, not every fall can be avoided. So it's particularly important for older people (and people who have diseases such as osteoporosis and osteoarthritis) to know how they can stay mobile and strengthen their muscles, bones and joints.

Cameron ID, Dyer SM, Panagoda CE et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2018; (9): CD005465.

De Souto Barreto P, Rolland Y, Vellas B et al. Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis. JAMA Int Med 2019; 179(3): 394-405.

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM). Hausärztliche Leitlinie: Multimedikation. Empfehlungen zum Umgang mit Multimedikation bei Erwachsenen und geriatrischen Patienten (S3-Leitlinie). AWMF-Registernr.: 053-043. 2021.

García-Hermoso A, Ramirez-Vélez R, Sáez de Asteasu ML et al. Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med 2020; 50(6): 1095-1106.

Gillespie LD, Robertson MC, Gillespie WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; (9): CD007146.

Hopewell S, Copsey B, Nicolson P et al. Multifactorial interventions for preventing falls in older people living in the community: a systematic review and meta-analysis of 41 trials and almost 20 000 participants. Br J Sports Med 2020; 54(22): 1340-1350.

Lee J, Negm A, Peters R et al. Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: a systematic review and meta-analysis. BMJ Open 2021; 11(2): e035978.

Lee SH, Yu S. Effectiveness of multifactorial interventions in preventing falls among older adults in the community: A systematic review and meta-analysis. Int J Nurs Stud 2020; 106: 103564.

Reeve E, Jordan V, Thompson W et al. Withdrawal of antihypertensive drugs in older people. Cochrane Database Syst Rev 2020; (6): CD012572.

Sherrington C, Fairhall N, Wallbank G et al. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. Br J Sports Med 2020; 54(15): 885-891.

Sherrington C, Michaleff ZA, Fairhall N et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 2017; 51(24): 1750-1758.

Wylie G, Torrens C, Campbell P et al. Podiatry interventions to prevent falls in older people: a systematic review and meta-analysis. Age Ageing 2019; 48(3): 327-336.

Zhao R, Bu W, Chen X. The efficacy and safety of exercise for prevention of fall-related injuries in older people with different health conditions, and differing intervention protocols: a meta-analysis of randomized controlled trials. BMC Geriatr 2019; 19(1): 341.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas - either via our form or by gi-kontakt@iqwig.de. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Über diese Seite

Updated on May 3, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.