Did you know that nationwide, an older adult is treated in an emergency department for a fall-related injury every 14 seconds.  Unfortunately, about one-third of people over the age of 65 will fall each year.  This statistic swells to almost 50 percent for those 80 and older.  In 2012, the Centers for Disease Control and Prevention estimated the direct medical costs of falls to be $30 billion.  Although common, falling during aging is not normal. 

Human balance is very complex and is composed of information that comes from 3 different systems in the body.  The first of which is our vision.  Have you ever noticed that balance gets more difficult in a dark room, or when you close your eyes?  It’s because we depend greatly on our vision for feedback on our body’s location.  Often, we become more dependent on vision as we age due to changes in the other two feedback systems. The somatosensory system consists of special sensors located throughout your muscles, tendons, joints and skin.  These sensors transmit data about stretch, vibration, touch, and pressure to your brain to help control how your body moves.  This system is challenged heavily on uneven surfaces such as grass or sand.  The final slice of feedback is provided by the vestibular system.  These balance organs are located in the inner ear and provid feedback on the position of your head.  It’s this system that makes you feel woozy after getting off a merry-go-round or a high speed elevator.  The brain’s ability to quickly integrate information coming from all three of these systems, in addition to performance of other tasks, is absolutely amazing.

Although these systems are responsible for the input of information about balance to the brain, sometimes falls are a result of the body’s ability perform a response.  Muscle weakness or restricted range of motion, for example, could prevent the body from responding appropriately even with the correct information input.  This is why physical therapists perform an in-depth assessment when first meeting a patient.  We strive to identify the impairments that are causing falls and treat those.  Sometimes falls may be related to a number of variables combined, rather than one particular problem.  They may even include risk factors that require communication with the primary care provider to ensure a well-rounded treatment.  Several situations that would require this include: medications, depression and visual, neurological, or cardiovascular deficits. 

Many different strategies have been introduced to decrease the risk of falling.  Some of the most common recommendations include:

  • Increase lighting around the house, including bedroom and hallway lighting.
  • Removal of rugs and addition tripping hazards such as power cords.
  • Organize a clear path of travel throughout your house with limited furniture barriers. 
  • Add grab bars or railings as needed, especially around the toilet, tub, and stairs.
  • Utilize annual wellness visits to your primary care provider for risk factor identification.
  • Work with a physical therapist to establish a safe, yet challenging home exercise program that can be completed year round.

Falls are the leading cause of both fatal and nonfatal injuries for those ages 65 and older.  The prevention of these situations is of utmost importance. Below are some basic screening tests that may identify your risk of falling.  The purpose of this webpage is to empower you to make a difference in your own healthcare.  Falls are not a normal part of aging, and unfortunately, they can lead to a reduction in quality of life or even a shortened lifespan.  If you’re at risk, talk to your primary care provider about treatment strategies to increase your chance of success!

    This is a simple screen of your balance and fall risk.

    Attempt to stand on one foot.  If you are unable to hold this stance for 5 seconds or longer, you may be at an increased risk for falls.

    Make sure you attempt this in a safe environment, with a sturdy surface to hold onto if loss of balance occurs.

    This is a simple screen of your balance and fall risk. 

    Attempt to stand with one foot in front of the other, heel touching toe.  If you are unable to hold this stance for 10 seconds or longer, you may be at an increased risk for falls.  

    Make sure you attempt this in a safe environment, with a sturdy surface to hold onto if loss of balance occurs.

    30 Second Sit to Stand

    This is a simple screen of your balance and fall risk. 

    This test is performed in a chair that’s about 17 inches from the floor.

    1. Sit in the middle of the chair.
    2. Place your hands on the opposite shoulder crossed at the wrists.
    3. Keep your feet flat on the floor.
    4. Keep your back straight and keep your arms against your chest.
    5. Rise to a full standing position and then sit back down again.
    6. Repeat this for 30 seconds.
    7. Count full repetitions only.

    If you’re unable to perform this test without the use of your hands, or if you’re at or below the score in the chart below, you may be a high risk for falls.

    Age: 60-64         Men: 13                 Women: 11

    Age: 65-69         Men: 11                 Women: 10

    Age: 70-74         Men: 11                 Women:  9

    Age: 75-79         Men: 10                 Women:  9

    Age: 80-84         Men:  9                  Women:  8

    Age: 84-89         Men:  7                  Women:  7

    Age: 90-94         Men:  6                  Women:  3

    Timed Up and Go (TUG)

    This is a simple screen of your balance and fall risk. 

    Wear normal shoes and use a walking aid like a cane or walker if needed.  Identify a line 10 feet away on the floor.  

    1. Start timing when you begin to rise from the chair.  
    2. Walk to the identified line on the floor at a normal pace.
    3. Turn and walk back to the chair at a normal pace.
    4. Sit down and end timing upon completion of the sit.  

    Taking longer than 12 seconds to complete this task may mean you have an increased risk of falling.