Understanding the Rising Risks: Why Falls are Becoming More Fatal for Older Adults

Walking the dog shouldn’t feel dangerous, but for Earl Vickers, it did. The 69-year-old retired engineer faced troubling falls while walking Molly, his mixed breed dog, in Seaside, California.

“I was falling nearly every month,” Earl recalls. On one occasion, he fell backward, hitting his head on a wall. Another time, he broke bones in his hand while trying to catch himself. After struggling with falls linked to a cancer medication called enzalutamide, he chose to stop taking it. Remarkably, he hasn’t fallen since.

Falls among older adults are a major health concern. According to the CDC, over 41,000 Americans aged 65 and older lost their lives due to falls in 2023. What’s alarming is that the death rate from fall-related injuries has tripled over the past 30 years. For those over 85, it soared to 339 deaths per 100,000 people, up from 92 in 1990.

The rise in fall-related deaths has drawn the attention of experts, including epidemiologist Thomas Farley. He believes that a significant factor in this trend is the growing use of certain prescription drugs—specifically those affecting the central nervous system, which can cause drowsiness or dizziness. Common examples include benzodiazepines and opioids.

Older adults often take multiple medications, leading to a concerning category known as “fall-risk-increasing drugs” (FRIDs). According to Dr. Michael Steinman from UCSF, these medications can raise fall risks by 50% to 75%.

Efforts to curb falls among seniors have been ongoing. The American Geriatrics Society updated its fall prevention guidelines in 2011, and the CDC launched its STEADI program shortly after. Yet, despite these measures, the problem persists and has worsened, according to researchers like Donovan Maust from the University of Michigan.

Interestingly, while some types of prescriptions have decreased, others—like antidepressants—have surged. This ongoing trend raises questions about the best approach to medication for seniors. Many experts advocate for “deprescribing,” a practice aimed at reducing unnecessary medications.

Dr. Thomas Gill, a geriatrician and falls researcher, emphasizes the need for older adults to engage with their healthcare providers. Patients should inquire about any medications that may increase fall risks and discuss alternative treatments. Addressing this can significantly enhance overall safety and well-being for seniors.

Falls are a pressing issue that impact many lives, so staying informed and proactive about health can help mitigate risks—for Earl and many others. The increased awareness, as well as the support for deprescribing, is essential in tackling this growing public health concern.



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