Causes of Falls

In Singapore, about one-third of older people aged 60 and above have fallen more than once. The main factors causing a healthy elderly person to fall are environmental ones, such as tripping over furniture or slipping over floor rugs.

Older adults who are frailer may be more susceptible to falling, especially if they experience dizziness or have difficulty in walking. Thus, risk factors for falls among older people can either be due to personal factors or environmental factors.

Personal Reasons:

  • Declining health, mobility and strength
  • Impaired balance and coordination
  • Impaired cognition
  • Medical conditions that affect vision, muscle strength or reflexes, e.g. Parkinson's disease, cataracts, high blood pressure, stroke, etc.
  • Medications that can cause unsteadiness and/or affect balance, vision or alertness, e.g. sedatives, blood pressure medications
  • Lack of physical activity, poor muscle tone and strength
  • Fatigue
  • Inadequate nutrition and diet

Environmental Reasons:

  • Uneven, loose and slippery surfaces
  • Unsecured carpets, rugs
  • Loose cords and wires
  • Inadequate/poor lighting
  • Poor step and stairway design
  • Chairs and beds that are too high or too low
  • Inappropriate footwear
  • Inappropriate eyewear

1-2-3 to Preventing Falls

  1. Have regular reviews with your doctor or a trained healthcare professional. A routine review can lower your chances of falling. Schedule a review:
    • To have your vision checked regularly.
      • Glasses with the wrong prescription and medical conditions such as glaucoma or cataracts may affect your vision and thus increase your risk of falling.
    • To review your medications.
      • Some medications or combinations of medications can cause side effects such as drowsiness and increase your risk of falling.
    • Before starting on any medications.

  2. Engage in regular physical activity. Physical activities and keeping active can make you stronger, lower your chances of falling and improves your quality of life.
    • Ask your doctor what types of physical activity would be best for you.
    • Have a plan for regular physical activities that fit your interest and abilities.
    • Do a mix of physical activity, especially strength, balance and flexibility exercises at least 3 days a week.
    • For more information, refer to this website: Singapore Physical Activity Guidelines (SPAG)

  3. Make your home safer. Fall-related injuries occur mostly at home. To make your home safer:
    • Remove floor rugs or use a non-slip backing
    • Coil or tape cords and wires next to the wall so that you don't trip over them
    • Minimise cluttering of furniture
    • Fix loose or uneven steps
    • Install grab bars and non-skid tape in the shower
    • Ensure that entrances, stairways, and rooms are well lit

Fall Prevention in a Nutshell:

  • You can control some of your personal risks of falling by optimising your health and vision.
  • You can decrease your risk of falling in the home by reducing environmental hazards, such as removing slippery rugs or loose wires.
  • You can reduce your risk of falling by doing a mix of physical activity, especially by doing strength, balance and flexibility exercises at least 3 days a week. 

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