Matt Handcock

Falls among older people: a source of justifiable concern

5 March 2024

Falls are a leading cause of disability and death among older people. As populations age, we must focus on responding to this growing challenge.

Falling is a common fear and a significant source of anxiety and concern for many older people. According to a recent survey conducted by Age UK, millions of older people are worried about the possibility of falling, with 36% of participants identifying it as their top concern.

This is an entirely understandable fear. After all, it is estimated that 684,000 people die from falls annually around the world – and the largest proportion of these deaths will occur among older people.

The cost of falling

Many countries have increasingly ageing populations, meaning that falls and related deaths will likely continue to grow. Over the past 10 years, older adult fall deaths have increased by 60% in the US.

Falls also often lead to injury. Around the world, 37.3 million falls per year are severe enough to require medical attention. Injuries can range from minor cuts and bruises to severe fractures, paralysis and even death. In the US alone, 36 million falls occur each year, leading to 8 million injuries and 950,000 hospitalisations – costing the health system $50 billion.

The older we get, the more susceptible we are to major risk factors for falling.

People aged 65 and older have the highest risk of serious injury arising from a fall. Hip fractures are a significant injury associated with falling among older people, with long hospitalisation periods. At any given time in England, Wales and Northern Ireland, 3,600 hospital beds are occupied by older people recovering from hip fractures.

But what causes older people to fall, and what can we do to prevent it?

Ageing is associated with many major risk factors for falling

Many falls will have an external cause such as missing a step or slipping on ice. But as people age, they are also more likely to fall due to a combination of physical, sensory and cognitive changes.

The older we get, the more susceptible we are to major risk factors for falling. These include worsening eyesight and hearing, cognitive impairment, age-related loss of muscle mass, poor foot health, and various health conditions (e.g. diabetes, heart or lung disease). Certain conditions, such as osteoporosis, make falling more dangerous as they can increase the risk of bone fractures.

Other significant risk factors include home or community environments that do not consider the needs of older people or are poorly adapted.

Proactive and multidisciplinary measures across health and social care are needed to address major risk factors and mitigate the burden of falls among older people.

How can older people be supported to reduce their risk of falling and feel safer?

We can – and should – all aim to support older relatives, friends and neighbours by recognising and removing hazards that may cause them to fall. But ultimately, proactive and multidisciplinary measures across health and social care are needed to address major risk factors and mitigate the burden of falls among older people.

It is vital that people who fall, and their carers and loved ones, report falls to a healthcare professional. This can initiate an assessment of the older person’s needs and identify any risk factors that can be mitigated through appropriate support and care. For someone who has fallen previously, increasing levels of support and adjusting levels of existing care may be necessary.

Whether they be preventive or in response to a fall, measures should be focused on the person’s individual needs. This requires central oversight to coordinate different health and social care professionals – such as primary care physicians, community nurses and home safety assessors – to work together.

Many charities offer support for older people and have published helpful resources. For example, Age UK has recently published a staying steady guide to help older people reduce their risk of falling, while the Parachute charity in Canada has a resource hub covering topics from home modification to optimal footwear.

To find out more about osteoporosis and how to progress policy to help people avoid fragility fractures, read our policy toolkit.

Falls among older people: a source of justifiable concern

Falls are a leading cause of disability and death among older people. As populations age, we must focus on responding to this growing challenge.

The cost of falling

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Ageing is associated with many major risk factors for falling

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The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.