Preventing falls as you get older – and how exercise can help

About 1 in 3 adults aged 65 and over and 1 in 2 adults aged 80 and over¹ living in the UK has at least one fall each year. Preventing falls² among older adults is a priority worldwide. And in addition to easy changes at home and with self-care, there’s evidence that exercise can help prevent dreaded falls.

Why is it important to prevent falls?

Having a fall affects not just your body (pain, bruises, fractures, and possibly death) but may also affect your confidence, your independence, and your mental health – a fall can lead to depression.

Hip fractures from a fall are particularly dangerous. According to the National Hip Fracture Database 2024 Annual Report³, more than 70,000 people in England, Wales and Northern Ireland fall and suffer a hip fracture every year resulting in the use of numerous hospital beds (1 in 30) costing the NHS about £70,000 yearly. Most people survive (95%, or 19 out of 20) but there is a 31% (1 in 3) 1-year mortality rate.

Importantly, a fall is the biggest cause of an older adult losing their independence and entering long-term care.

Image credit: Raul Muñoz

How to reduce the risk of falls

Follow these tips to reduce your risk of falls, at home and out and about:

Personal	Medical	At home
Make sure you eat well to keep your blood sugar stable. Drink plenty of fluids to prevent feeling dizzy from dehydration. Limit your alcohol intake. Do exercises to improve your strength and balance (see below). Get help to do things you can't safely do on your own. Wear snug shoes that are in good condition and support your ankles. Take care of your feet by trimming your toenails regularly. Use a walking stick or a frame. Don't wear loose-fitting, trailing clothes that might trip you up. Don't walk on slippery floors or stairs in socks or tights.	Have your vision, hearing, and blood pressure checked regularly. See your GP or a chiropodist if you have any foot problems. Ask your GP if you have a medical condition (such as Parkinson's disease or low blood pressure) that can increase the risk of falls. Ask your GP if you take any medication that can increase the risk of falls.	Install grab bars in the shower or bath, and handrails for both sides of the staircase. If your sight is impaired, use colour-contrasting handles and grab bars. Make sure that all rooms, passages and staircases are well lit. Remove floor clutter, trailing wires and frayed carpets that might trip you. Mop up spills immediately. Use non-slip mats and rugs. Remove mats and rugs if you find yourself tripping on them. Organise your home so you reduce climbing, stretching and bending, and don't bump into things.

Sources: NHS⁴, Mayo Clinic⁵ and the National Institute of Aging⁶

The good news: exercise can make a difference

Exercise may be the best way to prevent falls. An umbrella review (a review of systemic reviews) by Meulenbroeks, I. and colleagues published in 2024⁷ found that exercise was beneficial for older adults in residential care homes and community settings for multiple fall-related situations: number of falls, fall-related fractures, and hospitalisation due to falls.

Older adults are advised to exercise regularly, particularly exercises targeting balance⁸ and muscle strength⁹.

The NHS¹⁰ provides guidance on various intensities and types of useful exercises. The NHS website has instructions for balance and strength exercises^12,13. You can also see videos of simple exercises you can do at home without the need for special classes or equipment on the Johns Hopkins Medicine¹¹ website.

The World Health Organization (WHO) advises that adults aged 65 and older should aim to:

Do at least 150 minutes per week (about 21 minutes per day) of moderate physical activity, or at least 75 minutes per week (about 11 minutes per day) of vigorous physical activity, or a mix of both
Increase moderate physical activity (if possible) to 300 minutes per week (about 43 minutes per day) for additional health benefits
Do muscle-strengthening activities on at least two days per week
Do physical activities that improve balance and prevent falls on at least three days per week, especially if you have limited mobility

Multicomponent exercises have been shown to improve gait biomechanics and reduce the risk of falls in older adults. Gait is the way people walk, and biomechanics is the speed, step length, and phases of foot-ground contact15. Multicomponent exercise means something that combines more than one type of training in the exercise, such as aerobic, strength, balance, and flexibility. Examples of multicomponent exercise include yoga, Pilates, Tai Chi, walking, physical therapy, and dance.

A systematic review by Bai, X. and colleagues published in 2022¹⁶ reported that brisk walking improves muscle strength as well as heart and lung health. In addition, two systematic reviews published in 2024 found better postural balance in older adults participating in Pilates exercises (de Campos Júnior et al¹⁷) or Tai Chi (Li et al¹⁸). Additionally, a report by Ko et al¹⁹ noted that yoga has more of an impact on balance than on flexibility and muscle strength in older adults.

Shall we dance?

Dance offers many health benefits, including improved strength and balance. Older adults had better standing and balance and a reduced risk of falls, according to a 2022 systematic review by Blanco-Rambo et al²⁰ that pooled analysis of evidence from studies of dance interventions. The social and mental health benefits of dance are added bonuses.

An initiative that builds on this is Dance to health²¹, a falls-prevention dance programme for older adults. This programme operates in a number of parts of the UK and also offers online dance classes. Assessment of this programme showed a 58% reduction in the number of falls, as well as a potential saving of approximately £196m over 2 years, £158m of that for the NHS²².

Where you can get help

Many local health services have been rolling out programmes of fall prevention strategies. Ask your local hospital or community healthcare team for information about fall prevention. A falls risk assessment is available for people who have balance or gait issues or who report that they fall frequently. Ask at your local health centre if they offer this assessment.

You can find strength and balance classes in your area. Try the Otago Exercise Programme²³, a falls prevention programme developed in New Zealand that’s used widely in the UK and other countries.

You can also download fall-prevention exercise information from Age UK’s website²⁴.

Key points to consider

Preventing falls reduces injury, saves lives, preserves independence and saves money.
There is a lot we can do to prevent falls for ourselves, our family and our friends
Exercise programmes that include balance and strength training exercises – such as Pilates, Tai Chi, yoga and dance – all appear to reduce the risk of falls.
You can learn strength and balance exercises from the fall prevention team at your local hospital and other sources.
You can make changes to your home to reduce the risk of falls.
Ask your GP if you have a medical condition or medication that increases the risk of falling, and be sure to have your vision, hearing and blood pressure checked regularly.

Reviewed and updated by Mojitola Idowu, August 2025.