How common are falls after 65, and what actually reduces them

WHO’s 2007 global report puts falls at 28–35% of people aged 65 and over each year, and 32–42% of those over 70. In the US, the CDC’s September 2026 data page says more than one in four adults aged 65 and over, over 14 million people, report a fall each year.

Globally, WHO estimates 684,000 deaths from falls a year, which makes falls the second leading cause of unintentional injury death, and 37.3 million falls a year severe enough to need medical attention. Adults over 60 suffer the most fatal falls, and over 80% of fall deaths are in low- and middle-income countries.

In the US the trend is going the wrong way: the age-adjusted fall death rate rose 21%, from 64.7 to 78.4 per 100,000, between 2018 and 2024.

In the US, older adult falls lead to about 4.5 million emergency department visits a year. About 37% of people who fall report an injury that needs treatment or restricts their activity for a day or more. Falls cause 83% of hip fracture deaths, and nearly 319,000 older people are hospitalised for hip fractures each year.

The fall itself is only part of it. In a New Haven study of people aged 72 and over, 47% of fallers who were not injured could not get up unaided after at least one fall. Among people over 90 in Cambridge who fell, 80% could not get up at least once, and 30% lay on the floor for an hour or more. Those long lies were strongly linked to serious injury, hospital admission and moves into long-term care.

In the New Haven study, people with poor balance and gait were twice as likely to be unable to get up (relative risk 2.0). The Cambridge authors concluded that people need training in strategies to get up from the floor.

The best summary is a 2019 Cochrane review of 108 randomised trials: 23,407 people aged 60 and over in 25 countries, average age 76, 77% women. Against control groups, the rate of falls changed as follows:

• All exercise: 23% fewer falls (rate ratio 0.77), high-certainty evidence.
• Balance and functional exercise: 24% fewer (0.76).
• Several types combined, usually balance and functional training plus resistance: 34% fewer (0.66), moderate certainty.
• Tai Chi: 19% fewer (0.81), low certainty.
• Resistance training alone, dance or walking: effect uncertain.

A rate ratio of 0.77 means that people in the exercise groups had about 77 falls for every 100 in the control groups. The certainty grading is the reviewers’ judgment of how likely further research is to change the estimate.

Exercise also appeared to reduce fall-related fractures (risk ratio 0.73), though that evidence is low certainty. WHO’s fact sheet likewise lists gait, balance and functional training, and Tai Chi, among effective measures for older people.

"Uncertain" for resistance training alone does not mean it does nothing. It means the trials could not tell. Resistance training does appear in the most effective category, combined with balance and functional work.

The trials were in people over 60, average age 76, mostly women. They show that exercise taken up in later life reduces falls over the trial period. They say nothing direct about whether training in your 40s prevents falls in your 80s. That is a reasonable hope, but it has not been tested.

The figures for how often people fall rest on self-report and, for WHO, on studies cited in a 2007 report. They are good enough to say that falls are common after 65. They are not precise to the percentage point.

In a prospective study of 1,618 people over 65, the five-times sit-to-stand was the only one of three balance tests that added value in predicting recurrent falls; the others were one-leg balance and the Timed Up and Go. Taking more than 15 seconds doubled the risk in the moderate-risk group.

That is a risk marker in a group of older adults, not a prediction for one person, and falls were recalled once, 18 to 36 months after testing. Normal times by age are in our sit-to-stand article.

If you have already fallen, or feel unsteady, talk to a doctor or physiotherapist. This article is not medical advice, and a home test is not a falls assessment.

Longstanding’s three stability tests, the single-leg stand, the sit-to-stand and the floor sit-and-rise, measure the capacities this evidence keeps returning to: balance, leg strength and power, and getting up from the floor. The app makes no claim that its tests predict your fall risk, and it does not claim to prevent falls.

Its balance cue is a few minutes of single-leg practice a day. That is a small habit, not the structured programmes tested in the trials. One of its sixteen goals for 85, getting up off the floor with one hand, is there because of the long-lie studies above.