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What can cause a fall?

Falls do not have to be a normal part of getting older.

Despite what many people think, falls are preventable and do not just happen.

Often there are causes or risk factors that you may not have thought about which are linked to falling. These causes are grouped as being either personal risk factors or environmental risk factors. Personal risk factors are factors which impact you and your body; environmental risk factors relate to the world around you.

Personal risk factors for falls

Loss of balance

As we get older we can experience a loss of balance. Poor balance is a common cause of falls in older adults. Many factors can combine to affect your balance.

Your eyes and eyesight play an important role in helping you to keep your balance. Your eyes alert your brain to what is near you and help your body to make changes as you need to. Changes in your eyesight can stop your brain from receiving the correct information, and this will affect your balance.

Your muscles and joints store information about the position and movement of your body. This information is important so your body can change your position. You need strong muscles to support and correct any changes in your balance.

You may be at risk of a fall if you:

  • Feel unsteady on your feet
  • Have trouble walking on uneven surfaces
  • Use a walking frame or walking stick to steady yourself
Poor leg strength

Physical activity helps you to keep your muscle mass, bone strength and density, joint movement and stamina when you are doing daily tasks. Having strong muscles, particularly in your legs, is important to keep your body strong and supported as you move, to ensure you stay on your feet.

You may be at risk of a fall if you:

  • Find it hard to get up from a chair without using your arms
  • Do less than 30 minutes of physical activity each day
Having fallen before

If you have fallen before, you are at a greater risk of having another fall in the future. This may be because you are more fearful of falling, you are less confident in your ability to perform everyday tasks, or you reduce your levels of physical activity.

Health conditions

Sometimes you might not know the symptoms of your health condition, or you might believe that your symptoms are normal. You might also not want to bother your GP with minor problems. If left untreated, these symptoms can increase your risk of having a slip, trip or fall.

These symptoms may include:

  • Feeling dizzy, lightheaded or unsteady on your feet
  • Muscle weakness, stiffness or pain in your joints
  • Altered vision or trouble focusing.

You may be at risk of a fall if you:

  • Suffer from any of the symptoms listed above
  • Have a health condition such Diabetes, Arthritis, Parkinson's disease or heart problems
Taking five or more medicines

Medicines affect everyone differently. The side effects of medicines can increase your risk of falling.

Some side effects of medicines include:

  • Feeling tired, drowsy or confused
  • Feeling dizzy, lightheaded or unsteady
  • Blurred or double vision.

Sleeping tablets can continue to affect you into the daytime. They may make you feel sleepy and drowsy, make you feel dizzy, and cause problems with your balance which can increase your risk of falling.

You may be at risk of a fall if you:

  • Take five or more medicines
  • Take medicines to help you sleep better
  • Have not had your medicines checked by your GP or Pharmacist in the last year.

Alcohol can impact your judgement and how you perceive things. It affects your mental alertness, balance and coordination. It is important to drink responsibly and be aware of the effects of alcohol, particularly when combined with any medicines that you take. The effects of alcohol can increase when mixed with medicines, and this increases your risk of falling.

You may be at risk of a fall if you:

  • Drink alcohol while taking medicines
  • Drink more than two standard drinks on any day.
Poor diet

As you get older you might not feel like making and cooking meals. You may skip meals or just have tea and toast. Poor nutrition, not having proper meals or not eating enough food may make you feel dizzy and light-headed and may cause you to lose concentration.

Calcium is needed to develop and maintain your bone strength and prevent loss of bone density. It works with other minerals to make bones strong and healthy. Studies have shown that those who do not have enough calcium in their diet are at a higher risk of fracturing a bone if they fall.

You may be at risk of a fall if you:

  • Eat a diet low in calcium
  • Skip meals or don't eat breakfast
  • Miss out on eating foods from the five main food groups.

Not drinking enough water may lead to dehydration, as well as feeling confused and dizzy. Some people choose not to not drink very much water as they think it will make them rush to the toilet. Not drinking enough water concentrates your urine, irritates your bladder and increases your urge to go to the toilet. Rushing to the toilet can increase your risk of having a fall.

You may be at risk of a fall if you:

  • Often feel thirsty
  • Often find yourself rushing to the toilet.
Poor or changing eyesight

As we get older, our vision begins to change and deteriorate. Many of these changes are very gradual, so they are often ignored or unnoticed. Some common signs that are vision may be deteriorating include:

  • Constant frowning/squinting,
  • Frequent blinking,
  • Head tilting or turning,
  • Rubbing the eyes,
  • Holding reading material close to the face,
  • Poor eye-hand coordination or clumsiness,
  • Falls or bumping into items, and/or
  • Missing the cup when pouring drinks.

Our vision helps us to maintain our balance and identify hazards and obstacles in our environment that we can then navigate around. Therefore, if our vision is deteriorating it can increase our risk of having a fall.

Sore feet and unsafe shoes

We need good shoes to support our feet. Our shoes are our direct source of contact with the ground, so the shoes we wear can affect our posture, stability, balance, safety and gait. If we are not well supported, how can we stand tall, walk or move around efficiently?

Foot problems are painful and affect daily tasks and how we move about. People with foot problems often walk slowly and have difficulty doing tasks like housework and shopping. Foot problems can cause you to lose your balance and make you feel unstable on your feet. This can put you at a greater risk of falling.

You may be at risk of a fall if you:

  • Suffer from foot pain or other foot problems.
  • Do not undertake basic foot care.
  • Wear shoes that have a heel higher than 2 cm.
  • Wear shoes with inappropriate cushioning.
  • Do not have a slip resistant tread on your shoes.

Environmental risk factors for falls

Some common hazards that you may find inside your home are:

  • Poor lighting or not turning lights on
  • Trip and slip hazards such as objects left on the floor, loose mats and slippery floor surfaces
  • Uneven surfaces such as steps over doorways, shower hobs and stairs

Some common hazards that you may find outside your home are:

  • Wet and uneven paths
  • Tools and other objects left in the garden or in the garage

These hazards become more of a risk when combined with other risk factors such as poor eyesight, taking multiple medicines and wearing unsafe footwear.

To test your falls risk, try our online Falls Risk Checklist or to find out how to make your home safer try the online Home Safety Checklist.

To learn more about the role of strength and balance in falls prevention complete the Move Your Body online learning module today.

Stay On Your Feet® is provided by Injury Matters and funded by the Western Australian Department of Health.

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Government of Western Australia Department of Health Injury Matters
Injury Matters acknowledge the Whadjuk Noongar people as the traditional custodians of the land on which we live and work, and recognises Aboriginal and Torres Strait Islander peoples continuing connection to land, waters and community across Western Australia.