Falls prevention for older women: what the evidence shows
Falls prevention works best through strength and balance exercise, which cut the rate of falls by about a quarter in a Cochrane review (Sherrington et al., 2019). About 1 in 4 adults over 65 falls each year (CDC), which makes this one of the most practical of the women's health conditions to act on in later life.
Falls are common in later life, and a good share of the risk can be lowered. Falls prevention is the set of habits and checks that make a fall less likely and less harmful. This page is for women in their 60s and beyond, and for anyone helping a mother, sister or friend stay steady on her feet.
What is falls prevention?
Falls prevention means lowering both the chance of falling and the chance of being hurt if you do. It brings together strength and balance exercise, a look at your medicines, eye care and a few changes at home. In the US you will see it called falls prevention in older adults, for seniors or for the elderly; in the UK the usual phrase is prevention of falls in older people. It is the same idea.
Strength sits at the center of it. Muscle and strength decline faster from the 60s, especially without training, and low strength predicts falls and loss of independence (EWGSOP2, 2019). The hopeful part is that training is something you can add.
Most falls do not end in serious harm: the CDC reports that about 1 in 10 falls causes an injury needing medical treatment or a day or more of restricted activity. So this is less about fear and more about keeping the things you enjoy, like walking to the store, gardening or traveling.
Which steps have the best evidence?
Exercise has the strongest support of anything on the list. The Cochrane review behind the headline figure pooled trials of older people living in the community and found that programs combining balance and strength work did best (Sherrington et al., 2019). It is something you can start gently, at home or in a class.
US guidance agrees. The US Preventive Services Task Force (2024) recommends exercise for community-dwelling adults 65 and over at increased risk of falling, a Grade B recommendation. In the trials it weighed, exercise lowered the rate of falls by about 15%, a smaller number than Cochrane's that points the same way.
Medicines are the second place to look. Some cause dizziness or drowsiness, and both the CDC and the WHO list a medicines review among the steps that help. If you take several medicines, a yearly review is a sensible rhythm, and it's worth mentioning any dizziness. Some medicines, such as metformin and acid-reducers, also lower vitamin B12 absorption, which already falls with age; intake is 2.4 µg a day in the US and 1.5 µg in the UK.
Eyes and home come next. The CDC points to regular eye checks and to hazards around the house, which are often small things to fix.
Some services offer a multifactorial program, which brings several of these steps together after an assessment of your own risks. The USPSTF gives these a Grade C, meaning the decision to offer one is made case by case. They had a rate ratio of 0.84 for falls (below 1 means fewer falls), so the grade is not a sign that they fail.
The UK equivalent is the NICE guideline on falls assessment and prevention in older people (NG249, 2025); in the US the CDC's STEADI program gives primary care teams a framework for the same job.
How much and how often should you do strength and balance exercise?
A sensible target is strength and balance training 2–3 times a week, which the Cochrane review identifies as the most effective way to prevent falls and keep independence (Sherrington et al., 2019).
Balance work can be simple: single-leg stands, heel-to-toe walking, tai chi or dance. Many women start beside a kitchen counter or a sturdy chair, holding on at first. If you have already fallen or feel at risk, the Otago program is a structured option to ask about.
Strength work matters as much as balance, and weight bearing exercises for osteoporosis are a good next read if bone strength is on your mind.
From 65, it's worth raising falls with your primary care provider (your GP in the UK) once a year: any falls, near-misses, fear of falling or slower walking, and a falls assessment or strength and balance class (CDC STEADI; NICE NG249, 2025).
If that feels like a lot right now, a few minutes on most days is a good place to start.
What did the studies show, and what did they not show?
The trials showed that exercise lowers the rate of falls across a group. They did not show that any one program prevents every fall, and the reviews do not land on a single number.
Reviews count falls per person over time, so they describe the odds for a group and can't say what will happen to one woman. Their figures describe older men and women together.
Falls cause most hip fractures (CDC), and one fracture greatly raises the chance of another (NOGG, 2022). So after any fracture from a minor fall, it's worth asking for a bone health assessment, which may include a DEXA scan.
A class, a home routine, tai chi or dance can each carry balance and strength work, so it is reasonable to pick the one you will enjoy enough to keep up.
Falls in older women by life stage
| Stage | Figure | Why | Read more |
|---|---|---|---|
| Childhood | None set | Falls checks begin from 65; this link is for the childhood years. | What changes |
| Puberty | None set | Falls checks begin from 65; this link is for the teenage years. | What changes |
| Reproductive years | 150 min/week in pregnancy | For the years before this one: moderate cardio and strength work, with care around falls risk in pregnancy (ACOG, 2020). | What changes |
| Perimenopause | 10 min most days | Single-leg work, yoga and stretching lay early groundwork for balance and joint health. | What changes |
| Menopause | 10 min most days | The same short routine, for joint comfort and fall prevention. | What changes |
| Postmenopause | 2–3 sessions/week | Strength and balance training, alongside a yearly falls check from 65. | What changes |
Guidance by country
Facts
Common questions
Does tai chi help prevent falls?
Both the CDC and the WHO name tai chi as a form of balance and strength exercise, so it fits within your weekly sessions. It suits many women who prefer a class and slow, controlled movement. Standing near a wall or chair for the first few sessions is a gentle way in.
How many older adults fall each year?
About 1 in 4 adults over 65, according to the CDC, so a fall is common and nothing to feel embarrassed about. About 37% of those who fall report an injury needing treatment or a day of restricted activity, which means most do not. Telling your doctor about even a minor fall gives useful information.
Does exercise lower the chance of being injured in a fall?
Yes, the evidence supports this. In the trials the US Preventive Services Task Force (2024) weighed, exercise lowered the rate of injurious falls by about 16% (a rate ratio of 0.84) among adults 65 and over at increased risk. So the benefit is fewer falls, and fewer of the falls that lead to harm.
Do vitamin D supplements prevent falls?
The USPSTF's 2024 statement on falls does not address vitamin D, and its 2018 statement advised against supplements to prevent falls. Whether you need vitamin D for your bones is a different question, and one to raise with your doctor or GP, who can look at your diet and bone health together.
What can I change at home to lower my risk of falling?
The CDC's advice centers on grab bars (handrails in the UK), railings on stairs, good lighting and floors clear of clutter. Many women find it easiest to walk through the house one room at a time. In the UK, you can ask your GP about an occupational therapist home assessment.
What happens at a falls risk check?
In the US, the CDC's STEADI approach gives primary care teams three steps: screen for risk, assess what is behind it, and intervene with steps matched to you. In the UK, a falls risk assessment follows NICE guidance (NG249, 2025) and usually starts with your GP. Either way, it begins with a conversation about how steady you feel.
Next steps
A good place to start is one small step this week: a few minutes of single-leg stands beside a counter, or a call to ask your primary care provider or GP about a local strength and balance class. If you take several medicines, a review is worth asking for, and an eye check if one is due. It's worth seeing a doctor soon after a fracture from a minor fall, if falls or near-misses keep happening, or if dizziness or unsteadiness is getting worse. Falls prevention is not one size fits all, so choose the mix of exercise, checks and home changes that fits your body, your home and the life you want to keep living.
See a doctor promptly if you have
- symptoms that are getting worse, such as dizziness, unsteadiness or more frequent falls
- unexplained weight loss alongside feeling weaker or less steady on your feet
Sources
The guidelines and studies this page draws on.
- Exercise for preventing falls in older people living in the community (Sherrington et al.), Cochrane Database of Systematic Reviews (2019)
- Falls Prevention: Interventions to Prevent Falls in Community-Dwelling Older Adults (Recommendation Statement), US Preventive Services Task Force (2024)
- Facts About Falls, CDC (2026)
- Falls prevention: What You Can Do to Prevent Falls, CDC (2026)
- STEADI: About, CDC (2026)
- Falls (fact sheet), World Health Organization (2026)
- Sarcopenia: revised European consensus on definition and diagnosis (EWGSOP2, Cruz-Jentoft et al.), Age and Ageing (2019)
- Falls: assessment and prevention in older people and in people 50 and over at higher risk (NG249), NICE (2025)
- UK clinical guideline for the prevention and treatment of osteoporosis, National Osteoporosis Guideline Group (NOGG) (2022)
- Physical Activity and Exercise During Pregnancy and the Postpartum Period (Committee Opinion 804), ACOG (2020)