Falls After 65: The Yearly Toll, the Medicines That Raise the Risk, and the Exercises Proven to Help

The Centers for Disease Control and Prevention estimates 37 million falls among Americans aged 65 and older every year. Behind that number stand about 14 million people, one in four of us, who report at least one fall.

Gravity, it turns out, is the most patient adversary a person ever faces. It never sleeps, never takes a holiday, and never loses interest in you. Yet here is the encouraging part the grim numbers hide: many falls are not pure bad luck.

They are often the predictable result of a loose rug, a dim hallway, a sleeping pill, or legs that have been allowed to retire before their owner did. Each of those causes has a fix, and while no fix repeals gravity, the research says they can lower the risk considerably.

The Arithmetic of Gravity

The numbers deserve a moment of respectful attention, along with a word about what each one counts. The CDC estimates 37 million falls a year among adults 65 and older. Falls outnumber fallers because some people go down more than once; about 14 million older adults report at least one fall in a year.

The CDC's fact page, reviewed in September 2026, counts about 4.5 million emergency department visits from older adult falls each year. Of those visits, about 3.1 million end in treatment and release, and about 1.4 million result in hospitalization.

Nearly 319,000 hospital stays each year are for hip fractures, and in 2019, 88 percent of hip fracture emergency visits and hospitalizations were related to falls. The bill is heavy.

A CDC-authored study in the journal Injury Prevention put health care spending for nonfatal older adult falls at 80 billion dollars in 2020, most of it paid by Medicare. The trend runs the wrong way, too.

The CDC reports the fall death rate rose 21 percent between 2018 and 2024, and the National Safety Council counted 43,020 fall deaths among people 65 and older in 2024. None of this should frighten you into your armchair.

The armchair, as we shall see, is part of the problem.

Your House Is Not on Your Side

Many falls happen at home, in rooms we believe we know by heart. The house, alas, does not return our loyalty. The usual suspects are throw rugs that slide, electrical cords that wander across walking paths, dim stairways, and bathrooms with slick tubs and nothing to grab.

The CDC's prevention checklist is refreshingly plain. Remove or tape down loose rugs. Keep stairs clear and light them well, with switches at both top and bottom. Install handrails on both sides of every staircase, not just one.

Put grab bars in the tub, the shower, and beside the toilet, anchored into studs, not drywall. Add night lights along the route from bed to bathroom, since that midnight journey is where many falls occur.

Keep everyday items on low shelves so the step stool can stay in the garage. No checklist can promise you will never fall, but each item removes one way the house can trip you.

Some of these fixes take minutes and a few dollars. Others, such as a second stair rail, new light switches, or grab bars anchored into studs, call for a qualified handyman or an electrician, and the time and price depend on your house.

Measured against what a bad fall can cost, it is money thoughtfully spent.

The Medicine Cabinet Deserves a Second Look

Some of the most respectable bottles in the bathroom are quietly working against your balance. Sleeping pills and anti-anxiety drugs in the benzodiazepine family, such as diazepam and lorazepam, slow reaction time and linger into the next morning.

A CDC special report published in the Journal of Safety Research in 2020 found that older adults taking common antidepressants, the SSRIs and SNRIs, had about a 30 percent higher risk of falling than non-users. Blood pressure pills and diuretics can cause dizziness when you stand up quickly.

Even the humble allergy tablet diphenhydramine, found in many nighttime remedies, causes grogginess and confusion in older adults. The answer is not to quit anything on your own, which can be more dangerous than the fall.

The answer is a yearly medication review. The CDC's STEADI program trains pharmacists to screen for fall-risk drugs and work with your doctor to adjust doses, switch medicines, or change timing.

Taking a diuretic in the morning, for example, cuts down on risky nighttime bathroom trips. Bring every bottle, including the vitamins, and ask one question: which of these could put me on the floor?

Stronger Legs Are the Best Insurance Sold

The research here is cheering, if you read the labels carefully. A 2018 trial in JAMA Internal Medicine followed 670 adults aged 70 and older who had fallen before or had shaky mobility.

Those assigned to a specially tailored therapeutic program called Tai Ji Quan: Moving for Better Balance, practiced twice a week for six months, had 58 percent fewer falls than a group doing stretching exercises, and 31 percent fewer than a group doing standard aerobic and strength exercise. The result belongs to that specific program, not to any class with tai chi on the door.

More broadly, a 2019 Cochrane review of 108 trials found tai chi reduces the number of people who fall by about 20 percent. For those who prefer home, there is the Otago Exercise Program from New Zealand: 17 strength and balance exercises, individually prescribed and progressively adjusted by trained professionals such as physical therapists, done about three times a week with a walking plan.

Studies show it cuts falls by roughly 35 percent in frail, high-risk older adults. The common thread is balance work. A humble start: stand at the kitchen counter, keep a firm hand on it, and rise slowly onto your toes, adding harder moves only as your ability allows.

Eyes, Feet, and Bones

Balance is a committee, and several members deserve a checkup. The CDC recommends an eye exam every year, because an old prescription turns every step into a guess. Bifocal and progressive lenses deserve special caution on stairs, since the reading portion of the lens blurs exactly the spot where your foot is about to land.

Some eye doctors suggest single-vision glasses for outdoor walking. Feet matter, too. Shoes should fit snugly and have thin, non-skid soles. Walking around the house in socks on a wood floor is a stunt best left to the grandchildren.

Then there are the bones themselves. A bone density test estimates how likely your bones are to break in a fall; it cannot predict any single tumble, but it tells you and your doctor whether treatment for thin bones is worth starting.

Medicare generally covers the test once every 24 months for people who meet its eligibility rules, such as women whose doctors determine they are at risk for osteoporosis. Treating thin bones will not keep you upright, but it can change what happens if you do go down.

Finally, have your hearing checked. The inner ear is the body's level, and research links untreated hearing loss to balance trouble.

Tell the Doctor, Even if Nothing Broke

Here is a statistic with a story inside it: fewer than half of older adults who fall ever mention it to their doctor. The reasons are familiar to anyone with pride. Nothing broke, no sense making a fuss, and nobody wants to invite a lecture or, worse, a conversation about car keys.

But silence is costly. The CDC reports that falling once doubles your chance of falling again, partly because fear makes people move less, which weakens the very muscles that keep them steady.

A fall is not an embarrassment. It is a free diagnostic test, and it is foolish to throw away the results. The CDC's STEADI screening asks three questions: Have you fallen in the past year?

Do you feel unsteady when standing or walking? Do you worry about falling? Answer yes to any of them and you have earned a real fall-risk assessment, which checks your medicines, vision, blood pressure on standing, and leg strength.

Medicare's Annual Wellness Visit includes fall risk screening at no cost to you once you have had Part B for more than 12 months, so long as your provider accepts assignment; extra tests added during the visit can carry a charge. Use it.

The doctor cannot fix what the patient keeps secret.

Here is a weekend assignment that costs almost nothing. Walk through your house as if you were a nervous insurance inspector. Tape down or toss the loose rugs, add night lights between bed and bathroom, and put grab bars on the list.

Gather every pill bottle into a bag and ask your pharmacist which ones threaten your balance. Then ask your doctor or local senior center about an evidence-based balance program such as Tai Ji Quan: Moving for Better Balance or Otago; many communities offer them for little or nothing.

Finally, if you have fallen in the past year, say so at your next doctor visit, even if only your dignity was bruised. Gravity is undefeated, but it can be fought to a very long and comfortable draw.

Sources

• Centers for Disease Control and Prevention, Facts About Falls, cdc.gov/falls/data-research/facts-stats (page last reviewed September 2026)
• Haddad YK, Miller GF, Kakara R, Florence C, Bergen G, Burns ER, Atherly A, Healthcare Spending for Non-Fatal Falls Among Older Adults, USA, Injury Prevention 30:272-276 (published 2024; 2020 spending data), stacks.cdc.gov/view/cdc/164641
• Sherrington C et al., Exercise for Preventing Falls in Older People Living in the Community, Cochrane Database of Systematic Reviews, CD012424 (2019), cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/full
• Li F et al., Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling, JAMA Internal Medicine (2018)
• Special Report from the CDC: Antidepressant Subclass Use and Fall Risk in Community-Dwelling Older Americans, Journal of Safety Research (2020), stacks.cdc.gov/view/cdc/106471
• National Safety Council, Injury Facts: Older Adult Falls, injuryfacts.nsc.org (2024 data year)