Falls Prevention & Fracture Risk Guide: Stay Safe and Strong as You Age
This guide explains why falls are a leading cause of fractures in older adults, shares practical steps to reduce your fall risk, and outlines what to do if you experience a fall or fracture.
Falls are the top cause of fractures in adults 65 and older, but most falls are preventable. Simple home modifications, strength and balance exercises, and regular bone health checkups can significantly lower your fracture risk. If you do fall and suspect a fracture, seek medical care right away to avoid long-term complications.
Overview
Falls are the leading cause of fractures in adults 65 and older, with 1 in 4 older adults falling each year. Hip fractures alone affect more than 300,000 older adults annually in the U.S., and 20% of people who break a hip die within a year of the injury. The good news: most falls are preventable, and proactive steps can drastically reduce your fracture risk and help you maintain independence as you age. Adults who have fallen once are 2 to 3 times more likely to fall again, so early prevention is critical.
Signs & Symptoms of Elevated Fall or Fracture Risk
Many people don’t realize they have high fall or fracture risk until after a fall occurs, but these common warning signs may indicate you need to take preventive action: feeling unsteady when standing up, walking, or turning corners; needing to hold onto furniture, walls, or other people for balance; experiencing frequent dizziness, lightheadedness, or vision changes when moving; having weak grip strength or difficulty rising from a chair without pushing off with your arms; unexplained back pain or gradual loss of height (a possible sign of undiagnosed spinal fractures from osteoporosis).
Causes & Risk Factors
Fall and fracture risk stems from a mix of non-modifiable (unchangeable) and modifiable (changeable) factors. Addressing modifiable risks is the most effective way to prevent falls and serious fractures.
- Non-modifiable risks: Age 65+, female sex, family history of osteoporosis, previous fractures, chronic conditions like Parkinson’s disease
- Modifiable risks: Weak leg or core muscles, poor balance, untreated vision or hearing loss, medication side effects (drowsiness, dizziness), home hazards (loose rugs, poor lighting, missing handrails), low bone density (osteoporosis), dehydration, poor nutrition
Diagnosis & Risk Screening
There is no single test for “fall risk,” but healthcare providers use a combination of screenings to assess your individual risk and check for underlying bone weakness:
| Screening Type | What It Checks | Recommended Frequency |
|---|---|---|
| Fall risk assessment | Balance, gait, muscle strength, medication side effects, home safety hazards | At least annually for adults 65+ |
| Bone density scan (DEXA) | Bone strength and osteoporosis diagnosis | Every 2 years for adults 65+, or more often if you have risk factors |
| Vision and hearing tests | Sensory issues that increase fall risk | Annually for adults 65+ |
Treatment & Management
The goal of falls prevention and fracture risk management is to reduce your chance of falling and minimize bone damage if a fall does occur. Your provider will create a personalized plan based on your specific risk factors:
- Strength and balance training: Evidence-based programs like Tai Chi, or personalized physical therapy exercises, can reduce fall risk by up to 30%
- Home safety modifications: Install grab bars in bathrooms, remove loose rugs, add nightlights in hallways and stairways, ensure staircases have sturdy handrails
- Medication review: Ask your provider to audit all your prescription and over-the-counter medications for side effects that cause dizziness, drowsiness, or low blood pressure
- Bone health support: If you have osteoporosis, prescription medications (like bisphosphonates) combined with calcium and vitamin D supplements can strengthen bones and reduce fracture risk if you fall
- Assistive devices: Canes or walkers improve stability for people with balance issues; a physical therapist can help you select the right device and learn to use it safely
Living With Elevated Fall & Fracture Risk
Managing fall and fracture risk is an ongoing process, but small, consistent changes can help you maintain independence, mobility, and quality of life as you age:
- Stay physically active: Regular low-impact exercise like walking, swimming, or yoga keeps muscles strong and improves balance; aim for 150 minutes of moderate activity per week if your provider approves
- Wear supportive, non-slip footwear: Avoid loose slippers, high heels, or shoes with smooth soles; choose shoes with firm soles, good ankle support, and non-slip tread
- Prioritize nutrition and hydration: Drink plenty of water throughout the day to avoid dizziness, and eat a diet rich in calcium (dairy, leafy greens, fortified foods) and vitamin D (fatty fish, fortified milk, safe sun exposure) to support bone health
- Keep up with regular checkups: Schedule annual physicals, bone density scans, and vision/hearing tests to catch new risk factors early
- Plan for emergencies: Keep a phone or medical alert device within reach at all times, especially if you live alone, and share your fall risk plan with family or close friends
Medical Review Team
WellAlly Medical Editorial Team
This content is not a replacement for professional medical advice.
Recovery & management timeline
1-7 days
Initial Risk Screening (Days 1-7)
Schedule a fall risk assessment and bone density scan (DEXA) with your healthcare provider, review all your prescription and over-the-counter medications for side effects that increase fall risk, and do a walkthrough of your home to identify tripping hazards like loose rugs or poor lighting.
1-4 weeks
Early Prevention Implementation (Weeks 1-4)
Start a provider-approved strength and balance exercise program (like Tai Chi or physical therapy), make 2-3 high-priority home modifications (install grab bars in bathrooms, add nightlights in hallways and stairways, remove loose rugs from walkways), and start any prescribed calcium, vitamin D, or bone-strengthening medications.
Ongoing
Ongoing Maintenance (After 1 Month)
Continue strength and balance exercises 3+ times per week, schedule annual follow-up fall risk and bone density screenings, reassess your home for new hazards every 6 months, and adjust your management plan as your risk factors or health status changes.
Self-care steps
1Practice daily balance and strength exercises
Simple exercises like standing on one foot, heel-to-toe walks, or seated leg lifts can improve balance and leg strength. Aim for 10-15 minutes of exercise most days, and ask your provider for a referral to a physical therapist if you need guidance on safe, effective moves tailored to your abilities.
2Make targeted home safety modifications
Remove tripping hazards like loose rugs, electrical cords, and clutter from walkways; install grab bars in the bathroom next to the toilet and shower; add bright nightlights in hallways, stairs, and bedrooms; keep frequently used items within easy reach so you don’t have to climb or bend unnecessarily.
3Review your medications regularly
Ask your pharmacist or provider to review all your medications (including over-the-counter sleep aids, pain relievers, and allergy medications) at least once a year for side effects that cause dizziness, drowsiness, or low blood pressure. Never stop taking a prescribed medication without talking to your provider first.
4Prioritize bone health nutrition
Eat 3 servings of calcium-rich foods per day (like milk, yogurt, cheese, or fortified plant milks) and take a vitamin D supplement if your provider recommends it. If you have osteoporosis, take your prescribed bone-strengthening medications exactly as directed to reduce fracture risk if you fall.
5Move safely and wear proper footwear
Always wear non-slip, supportive shoes inside and outside your home; avoid walking in socks or loose slippers on hard floors. Stand up slowly from sitting or lying down to avoid dizziness, and use handrails on stairs every time, even if you feel steady.
When to seek medical help
Seek urgent medical care immediately if you experience any of the following after a fall: severe pain in your hip, back, wrist, or other bones; inability to bear weight on a limb; visible deformity or swelling in a joint or limb; confusion, loss of consciousness, or head injury; sudden loss of movement or sensation in a limb. If you have a minor fall with no obvious injury but feel unsteady or have new pain, schedule a same-day appointment with your provider to assess your fall risk.
Frequently asked questions
Will using a walker make me more dependent?
How can I improve my balance if I have arthritis?
Is osteoporosis the only cause of fractures from falls?
Can I still exercise if I’m afraid of falling?
Sources
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Medical Editorial Team · Last reviewed October 9, 2026. · Read our editorial policy