How Can Older Adults Reduce Their Risk of Falls?

Who thinks they’re at risk of having a fall?

It’s a simple question, but it often catches people by surprise. The reality is that everyone is at some level of risk of falling. While some individuals are more vulnerable than others, falls can happen to anyone, regardless of age or fitness level. 

However, falls become increasingly common—and potentially more serious—as we grow older. Understanding why falls occur and what we can do to prevent them is essential for healthcare professionals, older adults, and their families alike. 

Why Do Falls Matter? 

Falls are one of the most significant health concerns affecting older Australians. They are the leading cause of injury-related hospitalisations and deaths, accounting for almost half of all injury hospitalisations and deaths nationwide. 

For older adults, a fall can be life-changing. Beyond physical injuries such as fractures or head trauma, falls can lead to: 

• Loss of independence 

• Reduced mobility 

• Fear of falling again 

• Social isolation 

• Reduced quality of life 

The encouraging part is that many falls are preventable when risk factors are identified early and managed appropriately. 

What Is a Falls Risk? 

A fall is generally defined as an event that results in a person unintentionally coming to rest on the ground or another lower level. 

A falls risk refers to the likelihood of this occurring. 

Approximately one in three adults aged 65 years and older experiences a fall each year. This increased risk is often associated with age-related changes, including: 

• Reduced muscle strength 

• Impaired balance 

• Slower reaction times 

• Vision changes 

• Chronic health conditions 

Understanding the causes of falls is the first step towards preventing them. 

Understanding Falls Risk Factors 

Falls risk factors are typically grouped into two categories: intrinsic and extrinsic factors. 

Intrinsic Factors: What’s Happening Within the Individual? 

Intrinsic factors are those that relate directly to a person’s health and physical condition. 

Common examples include: 

• Muscle weakness 

• Balance impairments 

• Reduced mobility 

• Cognitive decline 

• Vision impairment 

• Neurological conditions such as Parkinson’s disease 

• Musculoskeletal conditions such as arthritis 

• Previous falls 

One of the strongest predictors of future falls is a previous fall. If someone has fallen before, their risk of falling again increases significantly. 

Extrinsic Factors: What’s Happening Around the Individual? 

Extrinsic factors are environmental or lifestyle-related hazards that increase the likelihood of falling. 

Common examples include: 

• Poor lighting 

• Loose rugs and clutter 

• Slippery or uneven surfaces 

• Lack of grab rails or handrails 

• Poorly fitting footwear 

• Restrictive clothing 

• Incorrectly adjusted walking aids 

These factors are often easier to modify and can have a substantial impact on reducing falls risk. 

The Physiotherapist’s Role in Falls Prevention 

Physiotherapists play a critical role in identifying and managing falls risk. Effective falls prevention generally involves three key stages: 

1. Screening

Screening helps identify individuals who may be at increased risk of falling. 

Current guidelines recommend routinely asking all adults aged 65 years and older, and 50 years and older for Aboriginal and Torres Strait Islander people, about any falls they have experienced within the previous 12 months. 

Questions may include: 

• Have you had any falls in the past year? 

• Do you experience dizziness or light-headedness? 

• Have you noticed changes in your balance or mobility? 

• Do you feel less confident when walking? 

2. Assessment

If a person is identified as being at risk, a more comprehensive assessment will be conducted by a physiotherapist. The assessment can look at multiple things. 

For example: 

• Strength deficits can be assessed through manual muscle testing or dynamometry. 

• Balance and postural control 

• Walking patterns 

• Vestibular dysfunction may be assessed  
• Environmental hazards can be identified through home assessments and discussions with the client. 

The more accurately we identify the contributing factors, the more effective our interventions become. 

Physiotherapists also use several outcome measures to evaluate balance, mobility, and functional performance to compare with standardised results and/or with the client’s previous results. These includes: 

• Timed Up and Go (TUG) 

• Berg Balance Scale 

• Functional Reach Test 

• Four-Stage Balance Test 

• 10-Metre Walk Test 

Among these, gait speed, measured using the 10-Metre Walk Test, is commonly used as a good indicator or predictor for falls in community-dwelling older adults. 

Assessment should go beyond simply identifying risk. It should aim to uncover the underlying causes. 

Once the underlying causes have been identified, treatment can be tailored to address those specific risk factors. 

3. Intervention

No two clients are exactly the same, which means falls prevention programs should always be individualised to the person’s goals, abilities, and identified risk factors. 

Interventions should target the specific deficits identified during assessment while remaining safe, achievable, and progressively challenging. 

Evidence-based interventions include: 

• Strength and balance training 

• Tai Chi 

• Group exercise programs 

• Reactive balance training 

• Cognitive-motor and exergame-based training 

• Functional task practice 

The Otago Exercise Programme 

One of the most widely recognised falls prevention programs is the Otago Exercise Programme. 

Research has shown that the program can reduce falls risk consistently. 

The program combines: 

• Lower-limb strengthening exercises 

• Static and dynamic balance training 

• Functional mobility activities 

Examples include: 

• Knee, hip, and ankle strengthening 

• Tandem standing 

• Single-leg stance 

• Sideways and backwards walking 

• Sit-to-stand practice 

• Stair climbing 

Consistent participation, regular review, and progression are key factors in achieving positive outcomes. 

These interventions aim to: 

• Improve balance and mobility 

• Increase lower limb strength 

• Reduce falls and fall-related injuries. 

In-Home Physiotherapy for Falls Prevention: 

For many older Australians, receiving physiotherapy at home can be one of the most practical and effective ways to reduce the risk of falls. Being treated in a familiar environment enables the physiotherapist to tailor treatment to the individual’s daily routines, physical abilities, and specific challenges.  

Benefits include: 

• Tailored support in a familiar environment 

• Identification of real home hazards 

• Identification of real-life challenges  

• Greater comfort and accessibility 

• Personalised, one-on-one care 

This is particularly suited to clients accessing: 

• Support at Home (SAH) 

• Commonwealth Home Support Programme (CHSP) 

• Private physiotherapy services 

• NDIS services. 

Falls Prevention Is a Team Effort 

While physiotherapists play a significant role, falls prevention should never occur in isolation. 

A successful falls prevention strategy requires collaboration across the multidisciplinary team. 

Occupational Therapists 

Occupational therapists help identify environmental hazards, assess home safety, and recommend equipment or modifications that support independence and reduce risk. 

Allied Health Assistants 

Allied health assistants play an important role in supporting exercise delivery, reinforcing treatment plans, and helping clients complete their programs safely and effectively. 

The Client and Their Family 

Perhaps most importantly, clients and their support networks must be actively involved in the process. Education, engagement, and shared goal-setting help improve adherence and long-term outcomes. 

When Should You Seek Professional Advice? 

Consider speaking to your GP or physiotherapist if you: 

• Have experienced one or more falls in the past year. 

• Feel unsteady when walking 

• Have noticed worsening balance. 

• Experience dizziness or fainting 

• Are fearful of falling and limiting activities  

• Have recently started medications that affect balance 

Seek urgent medical attention following a fall if there is: 

• Loss of consciousness  

• Significant head injury 

• Severe pain 

• Inability to stand or walk 

5 Simple ways to reduce falls Risk: 

1. Stay physically active 
2. Complete strength and balance exercises regularly 
3. Remove trip hazards from the home 
4. Ensure adequate lighting 
5. Have your vision and medications reviewed regularly 

If you are concerned about your balance, mobility or risk of falling, a physiotherapist may be able to assess your individual risk factors and discuss appropriate management options. 

Long term benefits of Falls Prevention Physiotherapy: 

Regular participation in falls prevention physiotherapy can provide the following long-term benefits: 

• Reducing falls risk over time 

• Improved mobility and independence 

• Prevention of muscle loss 

• Reduced hospitalisation and injury risk 

• Prolonging independence at home. 

Talk Health Therapy: 

At Talk Health Therapy, we specialise in falls prevention physiotherapy for older Australians, helping you stay safe, mobile, and independent. Our approach is grounded in evidence-based practice, with a strong focus on exercise therapy, personalised care, and long-term outcomes. 

We work closely with clients to develop programs that improve strength, balance, and mobility, while supporting independence and quality of life. Our services are designed to meet the needs of individuals across different funding pathways, including Support at Home (SAH), CHSP-funded services, and private physiotherapy. 

We support clients through: 

✅ Support at Home (SAH) 

✅ Commonwealth Home Support Programme (CHSP) 

✅ Private physiotherapy services 

✅ NDIS services. 

👉 We are your trusted physio provider for older Australians, providing both holistic and tailored care to each individual. Whether you are receiving SAH, CHSP or are privately funded, just reach out to us and our team will support you with a personalised falls prevention program. 

Final Thoughts 

A single fall can have far-reaching consequences, affecting a person’s confidence, independence, and quality of life. However, with the right approach, many falls can be prevented. 

As healthcare professionals, our goal is not simply to treat falls after they occur—it is to identify risks early, implement evidence-based strategies, and empower people to remain active, safe, and independent for as long as possible. 

After all, the best fall is the one that never happens. 

References 

1. World Health Organization. (2024). Falls Fact Sheet.

2. Australian Commission on Safety and Quality in Health Care. Preventing Falls and Harm from Falls in Older People: Best Practice Guidelines.

3. Montero-Odasso M, van der Velde N, Martin FC, et al. (2022). World Guidelines for Falls Prevention and Management for Older Adults. Age and Ageing.

4. Sherrington C, Fairhall N, Wallbank G, et al. (2019). Exercise for Preventing Falls in Older People Living in the Community. Cochrane Database of Systematic Reviews.

5. Campbell AJ, Robertson MC. (2003). Otago Exercise Programme to Prevent Falls in Older Adults.

6. Australian Institute of Health and Welfare. Falls in Older Australians.