Falls in Older Adults

A fall is a symptom, not a diagnosis. In an older adult, the event may reflect impaired balance, weakness, orthostatic hypotension, medication effect, visual or vestibular disease, neuropathy, cognitive change, or an environmental hazard—and several contributors commonly act together. More than one in four US adults aged 65 years and older reports a fall each year. The age-adjusted fall death rate increased from 64.7 per 100,000 in 2018 to 78.4 per 100,000 in 2024. The practical implication is not to search for one culprit and stop; it is to identify the interaction of modifiable risks, exclude injury and syncope, and restore safe function. CDC STEADI provides the primary-care structure: Screen, Assess, Intervene. Screen adults 65 years and older at least annually and screen again whenever an older adult presents after a fall. Ask whether the patient fell in the past year, feels unsteady when standing or walking, or worries about falling. A yes to any question means further assessment is needed, not reassurance that the fall was mechanical.