Preventing falls and traumatic brain injuries in older adults


Falling is not unique to seniors, but as we get older, normal changes associated with aging (such as decreased strength, increased medications and poor eyesight) make us more likely to fall and get hurt in the process. According to the Centers for Disease Control and Prevention (CDC), an older adult (age 65-plus) falls every second of every day – making falls the leading cause of injury and injury-related death for this age group.

Falls may result in hip fractures, broken bones and head injuries. They are also the most common cause of traumatic brain injury (TBI) in the United States. Approximately 80% of TBI-related emergency department visits, hospitalizations and deaths in older adults are related to falls.

What is traumatic brain injury (TBI)?

TBI results from an impact to the head that disrupts the brain’s normal function. The most likely impacts to cause TBI come from falling, being struck by an object and motor vehicle crashes.

Not all bumps and blows to the head cause TBI, and some cases of TBI are worse than others. Doctors classify TBIs as either mild (a concussion), moderate or severe. The classification refers to the time spent unconscious and the severity of the symptoms, which may include:

  • Blurry vision
  • Changes in emotions or sleep patterns
  • Confusion or disorientation
  • Dizziness
  • Headache
  • Nausea and vomiting
  • Ringing in the ears

No matter how severe the TBI is, long-lasting and disabling cognitive changes may occur. This can affect your ability to learn, remember new information and make sound judgements.

Assessing your fall risk

Once you know your risk for falling you can take steps to decrease the risk. According to the CDC, you may be more likely to fall if you have:

  • Balance or walking difficulties
  • Common tripping hazards at home, including throw rugs, clutter and broken or uneven steps
  • Fallen in the past year
  • Foot pain or ill-fitting footwear
  • Lower body weakness
  • Medications that affect balance or cause dizziness, including tranquilizers, sedatives, antidepressants and some over-the-counter medicines
  • Vision problems

The National Council on Aging recommends that you conduct a walk-through safety assessment of your home. Pay special attention to the stairs, lighting and bathrooms. Look for trip hazards inside and outside your home.

Preventing falls

According to the CDC, falling once after age 65 doubles your chances of falling again, so preventing that first fall is especially important. The easiest way to decrease your risk of falling is to take care of your overall health.

The National Institute on Aging recommends taking these steps to keep you on your feet:

  • Make your home safe: Remove any trip hazards and add extra lighting at the top and bottom of the stairs, if necessary. Add grab bars and handrails to bathrooms and steps. Make sure a light switch or lamp is within easy access from the bed for getting up in the middle of the night.
  • Review your medications: Discuss the medicines you take (including over-the-counter drugs) with a doctor or pharmacist to determine side effects that may make you prone to falling.
  • Stay active: Regular exercise will strengthen muscles, slow bone loss and improve your balance. Even if you’ve fallen before, continue to be active if possible – lessening your activity and exercise may leave you weaker, ultimately increasing your chances of falling again.
  • Talk to your doctor: Let your physician know if you feel dizzy or unsteady. Be open about trouble sleeping or urinary issues, which may cause you to get up at night and increase your risk of falling in the dark.
  • Test your vision and hearing: Poor hearing and eyesight are associated with greater fall risk. Get tested for both regularly and always wear glasses, contacts or hearing aids if you need them.

What to do if you fall?

It’s important to stay calm when you fall. Before you try to get up, take a few breaths and evaluate whether you are hurt. If you aren’t injured, get up slowly and use something to stabilize yourself.

If you are hurt or cannot get up on your own, ask someone to help or call 911. Whenever possible, carry your mobile phone with you, even in the house, so that you’ll have it on hand for emergencies.

Even if you don’t think you are injured, tell your doctor about the fall right away – especially if you might have hit your head when you fell. Your doctor can check you for injury, determine why you may have fallen and recommend steps to prevent additional falls.

If you’ve fallen recently or want to have your fall risk evaluated, reach out to your primary care provider.