About a third of people over 65 fall at least once a year. Falls are the leading cause of hip fracture and loss of independence in this age group. The good news: a substantial share of falls are preventable, and the most effective intervention is not medication but exercise.
What raises the risk
Personal factors:
- Loss of leg muscle strength (sarcopenia)
- Impaired balance and gait
- Reduced vision
- Dizziness, drops in blood pressure
- Taking four or more medications — particularly sleeping tablets, diuretics and blood pressure medication
- Foot problems: calluses, deformity, unsuitable footwear
- A previous fall — the strongest predictor of all
- Fear of falling: avoiding movement, losing muscle, raising risk further
Environmental factors:
- Slippery floors, curled rug edges
- Poor lighting, especially at night
- No handrail on the stairs
- No grab rail in the bathroom
- Cables and clutter
Three tests you can do at home
1. 30-second sit-to-stand On a chair without arms, arms crossed over the chest. Count how many times you can stand fully and sit in 30 seconds.
For women, fewer than 12 at 60–64 and fewer than 10 at 75–79 is considered low; for men, 14 and 11 respectively. A low score indicates weak lower-body strength.
2. Single-leg stand Time how long you can stand on one leg without holding on. Do it next to a wall or chair for safety.
Under 10 seconds warrants attention.
3. Timed up and go Stand from a chair, walk 3 metres, turn, come back and sit. Taking longer than 12 seconds is associated with fall risk.
A low score on any of these suggests a physiotherapy assessment would help.
The exercise programme with the evidence
The most effective fall-prevention programmes share a profile: at least three days a week, more than three hours in total, balance-focused and genuinely challenging. The challenge matters; exercise that is too easy does not produce a protective effect.
Balance (daily, 10–15 minutes)
Tandem stand: Stand in a straight line with the heel of one foot touching the toes of the other. 30 seconds, each foot in front. If you can do it without support, try it with your eyes closed — with something to hold nearby.
Single-leg stand: 10–30 seconds per leg, three times each. Do it beside a kitchen counter.
Heel-to-toe walking: Ten steps along a straight line, then back. A corridor works well.
Weight shifting: Feet shoulder-width apart, shift your weight slowly right, left, forward and back.
Strength (two or three days a week)
Sit-to-stand: Ten repetitions without using your arms, two or three sets. The most functional exercise there is.
Wall squat: Back against the wall, half squat, hold ten seconds, five repetitions.
Heel raises: Holding the counter, 15 repetitions, two sets.
Side leg raises: Standing, holding on, 15 repetitions each leg.
Step-ups: Up and down a low step, ten repetitions each leg.
Endurance
20–30 minutes of walking a day. It can be split: three ten-minute walks give the same benefit.
Home safety checklist
- Rug edges secured, or rugs removed
- Cables routed along the walls
- Grab rails fitted in the bathroom and toilet
- Non-slip mat in the shower
- Night lighting for the hallway and route to the toilet
- Handrails on both sides of the stairs
- Everyday items on shelves between waist and eye level, so no chair is needed
- Closed, non-slip shoes worn indoors rather than slippers
- Bed height allows the feet to reach the floor when getting up
Medication and eyesight
Review your full medication list with your doctor once a year, particularly if you take five or more. Sleeping tablets and some blood pressure and diuretic medications increase fall risk.
Have your eyes checked annually. Varifocal glasses can distort depth perception on stairs; take extra care coming down.
Vitamin D deficiency affects muscle strength and levels should be checked by your doctor.
Dealing with fear of falling
Fear of falling leads to less movement, less movement to muscle loss, muscle loss to higher risk. Breaking the cycle means not giving up movement but being challenged gradually in a safe setting. Supervised group exercise is particularly valuable here.
Frequently asked questions
Does using a walking frame make you weaker? A well-chosen, correctly adjusted aid increases independence. A stick at the wrong height increases risk — it should be set to your height.
Is there an age limit for strength training? No. Gains in muscle mass and strength have been demonstrated well into later life.
I fell but nothing was broken — do I still need to see a doctor? Yes. The cause should be investigated: blood pressure, heart rhythm, medication effects or a balance problem. One fall is the strongest warning of a second.
This article is general information and does not replace an examination. For a balance assessment and an individual fall-prevention programme, book an appointment at our clinic in Muratpaşa, Antalya.