Everybody takes a tumble now and then. They’re called accidents for a reason. But as the years go by, those falls can become more common. Every second, an older adult lands on the ground.¹ That makes falls the leading cause of injury in people over age 65.

In fact, about 36 million older adults fall every year. And 1 out of every 5 of those falls causes an injury that sends them to the ER.¹

While the physical dangers of falling are serious, the mental health ones can be, too. As many as 60% of older adults are afraid of falling. And many of them cut back on their activities because of it.

That fear can keep you from doing the things you love, and the things you need to do every day. Things like volunteering at the library to shopping for groceries.²

Even worse, a fear of falling can lead to even more falls. People who are stressed out about falling are almost twice as likely to fall as people who aren’t.³

Why? Stress isn’t just emotional. It’s physical, too. “When you’re scared and worried, you tighten your muscles,” explains Gary Kennedy, MD. He’s a past president of the American Association for Geriatric Psychiatry. “That makes you less flexible, which makes you more likely to fall.”

And staying inside isn’t the answer. That can lead to loneliness and depression. Plus, inactivity can even make you weaker. “It can be a vicious cycle,” says Sherri Betz, PT, DPT. She’s a specialist in geriatric physical therapy in Monroe, Louisiana. Betz is also a spokesperson for the American Physical Therapy Association. (Physical therapy uses movement to care for pain and weakness.)

“I’ve seen patients who have had a couple of falls get really afraid that it might happen again. They change the way they walk. They may start shuffling or stop walking completely,” says Betz. “As they sit more, their legs get weaker and their hips get stiff. That sets them up for another fall.”

But it doesn’t have to be that way. Here are four simple steps that can help you get over the fear of falling and back to the life you love.

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1. Talk to your primary care doctor. First, let them know you’re worried about falling. They can listen, offer solutions or send you to specialists who can help you get back in the game. Then ask them to review your medications with you. Some medications could cause you to fall.

A 2021 study looked at adults over 65 and the medicines they took. Nine out of 10 were taking medicines that could play a part in falling.⁴ So if you have medication for pain, anxiety, depression or sleep, find out if you can take less or manage those problems differently.⁵ (Do you need a new provider? We can help.)

2. Ask your doctor about seeing a physical therapist. They can help you improve your posture and learn better, safer ways to walk. Physical therapists are specially trained to check out your needs and make a plan just for you.

“We can talk about your fear of falling,” explains Betz. “We’ll show you what to avoid doing, like looking down while you’re walking or furniture surfing (when you hold on to furniture as you cross a room). Then we’ll give you ways to build up your leg strength and your balance. You’ll start to see yourself improving, and that can really build up your confidence.”

3. Take a class. Better balance is important to staying on your feet and preventing falls. Some science-proven ways to make your balance better:

• Tai chi. This practice involves slow, gentle, focused movements. It can help you control your breathing and calm your mind. Best of all, it’s a great way to improve your balance and prevent falls. In one study, older adults who took a tai chi class reduced their risk of falling by 50%.⁶ To find a class near you, check with your local community center. Your doctor or physical therapist may also be able to suggest a class.
   
• Group balance classes. Try programs like A Matter of Balance and Moving for Better Balance. They combine ways to improve balance with confidence-building tips. There are usually eight two-hour sessions. A recent study looked at older adults who took the Matter of Balance class. As many as 71% of those were afraid of falling. After taking the class, they said they were less afraid.⁷ Find out about programs near you through your local Area Agency on Aging.

4. Stay active. Try not to let a tumble in the past stop you from doing things you enjoy today. As best you can, try to push yourself a little to get moving. That includes reaching out to friends and family. It’s easy to feel isolated if you’re scared about what might happen if you go out.

One way to tackle those fears? Think about the possible obstacles and how you can get around them. If you’re worried about uneven sidewalks, a cane might give you extra support. If going out alone stresses you, ask a friend to pick you up.

“When you give up activities you enjoy, you stop the reward circuit in your brain,” says Dr. Kennedy. “Finding ways to reconnect that reward system makes you feel less sad. You can take more pleasure in activities you used to love.”

Once your confidence is up, you can do more. “Get out first thing in the morning,” advises Dr. Kennedy. “Have your cup of coffee and take a 30-minute walk. Then come back home, have breakfast and enjoy your day.”

Sources

1. Centers for Disease Control and Prevention. Keep on your feet — preventing older adult falls. Last reviewed December 16, 2020. Accessed September 2, 2022.
2. FBMC Geriatrics. Fear of falling is as important as multiple previous falls in terms of limiting daily activities: A longitudinal study. Published June 7, 2021. Accessed September 2, 2022.
3. Plos One. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? Published March 29, 2018. Accessed September 2, 2022.
4. Pharmacoepidemiology and Drug Safety. Trends in fall‐related mortality and fall risk increasing drugs among older individuals in the United States, 1999–2017. Published August 30, 2021. Accessed September 2, 2022.
5. Centers for Disease Control and Prevention. Medications linked to falls. Published 2017. Accessed September 2, 2022.
6. Journal of the American Geriatrics Society. Tai chi for risk of falls. A meta-analysis. Published July 24, 2017. Accessed September 2, 2022.
7. Journal of Trauma Nursing. A survey-based assessment of “matter of balance” participant fall-related experience. Published September 2021. Accessed September 2, 2022.

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