Falling With Age: Risks, Prevention, and What to Do If You Fall

Age brings many health concerns, but the fear of falling almost certainly increases with each passing year. Already the most common reason for older adults to be admitted to the hospital, falls are on the rise. Ireland has one of the fastest ageing populations in Europe, and recent statistics from the Irish Longitudinal Study on Ageing (TILDA), published in the journal BMJ Open, revealed how falls are taking their toll on society, with one in eight older people in Ireland requiring medical attention for a fall each year.

The Impact of Falls

As the most common cause of fractures among older adults, falls are a leading contributor to reduced mobility, loss of independence, and hospital admission. Without intervention, those who fall once are at significantly increased risk of doing so again. In Ireland, there are an average of 27,000 calls from older people who have fallen each year, with approximately 80% requiring hospital care.

Falls can result in fractures or head injuries, but also soft tissue and skin injuries, particularly if individuals are left lying on the floor unattended. Gaps in medical specialists dedicated to falls management can hinder long-term recovery.

The FaME Programme: A Proactive Approach

To address this growing concern, Dr. Ruth McCullagh, a senior lecturer and physiotherapist at University College Cork, is spearheading the rollout of the Falls Management Exercise (FaME) programme in Ireland. This 26-week course aims to reduce falls and their impact on health by teaching participants how to get up from the floor independently and by teaching postural stability techniques to prevent falls.

“Qualified practitioners combine strength and balance training with safe floor-rise practice, using soft mats, in a safe environment,” explains Dr. McCullagh. “Not all exercises include balance, which people sometimes assume is the only important factor in fall prevention, as you do need a combination of strength exercises using a resistance band and functional balance work for the outcome to be effective.”

Currently, the FaME programme, originally developed by Professor Dawn Skelton at Glasgow Caledonian University, is available in select areas of Cork, Kerry, Mayo, Sligo, Galway, and Dublin, with efforts underway to expand its reach.

Medication and Specialist Access

TILDA findings also highlight concerning trends in healthcare practices related to falls. Over half of older adults attending emergency departments after a fall were prescribed medications known to increase falls risk, including drugs affecting balance, alertness, or blood pressure. More than one in five did not have access to a specialist falls assessment clinic.

Why Do We Fall as We Age?

Balance deteriorates with age, but many other factors contribute to fall risk. A loss of muscle mass, known as sarcopenia, which begins in midlife, can reduce strength and increase susceptibility to falls. The number of motor neurons—nerve cells controlling balance and movement—decreases with age. By age 75, approximately 40% of these neurons have been lost, leading to reduced coordination and balance.

Can Balance Training Assist?

Balance training is a crucial component of falls prevention. Practicing functional balance exercises, such as standing on one leg while reaching or bending, can improve stability. A 12-year study involving 1,702 people aged 51-75 found that an inability to stand unsupported on one leg for 10 seconds was associated with an 84% increased risk of death from any cause.

FaME Exercises: Professional Guidance is Key

While strength and balance maintenance work can be practiced at home, Dr. McCullagh emphasizes the importance of professional guidance for the FaME programme. “The evidence suggests you can’t really improve your balance on your own if it is very poor to start with,” she says. “You are much better off going to see someone who can help to train it properly.” Consulting a GP for recommendations on local exercise classes or physiotherapists is advised.

Falls Risk Isn’t Limited to the Elderly

While often associated with older adults, falls are a significant risk for people of all ages. Falls are the number one cause of trauma-related death and injury across all age groups, with approximately 30% of adults experiencing a fall in the past 12 months. Balance is influenced by factors like muscle strength, coordination, hormones, fatigue, stress, and even footwear.

Practice Getting Up

All adults over the age of 50 should practice getting up from the floor every two weeks. “It’s a learned action, and the more you know you are able to get up, the better your confidence will be if you do experience a lousy fall,” says Dr. McCullagh. “You will never fall in exactly the same way, so practice getting up from different positions.”

What to Do If You Fall

If you fall, take a few minutes to catch your breath. If possible, roll onto all fours and crawl to a sturdy object for support. Bend your stronger knee and tuck the foot of your weaker leg underneath your body, then use your hands to push yourself up.

Safety Precautions

• Keep your phone accessible: Carry it with you or ensure your alarm system is functioning correctly.
• Don’t try to lift someone who has fallen: Guide them to a seated position instead of lifting to avoid injury.