Falls prevention for adults 65 and older
For adults 65 and older who live at home and are at higher risk of falling, the USPSTF recommends exercise programs (grade B, 2024). A wider, personal fall-risk plan is a case-by-case choice (grade C). (USPSTF, 2024)
These recommendations are for older adults living at home, not in a nursing home or other institution. If you have fallen, feel unsteady or are worried about falling, tell your doctor.
- USPSTF grade
- B (exercise), C (multifactorial)
- Who
- Adults at increased fall risk
- Ages
- 65 and older
- Vitamin D for falls
- Draft: do not take it for this
What helps, by grade
| Approach | USPSTF grade | What it means |
|---|---|---|
| Exercise: mostly gait, balance and functional training, often with strength training | B (2024) | Recommended for adults 65 and older at increased fall risk |
| Multifactorial plan: a check of fall risks, then steps for each one found | C (2024) | Offered case by case; the net benefit of offering it to everyone is small |
| Vitamin D to prevent falls | D in a draft (2024), not final | The draft recommends against it for postmenopausal women and men 60 and older |
In the trials the USPSTF reviewed, most exercise programs used gait, balance and functional training, and about two thirds added strength and resistance training. Exercise reduced the number of falls. (USPSTF, 2024)
A multifactorial plan starts with a check of risks that can be changed, such as balance, gait, vision, blood pressure on standing, medicines, the home, memory and thinking, and mood, and then adds steps for each problem found. Whether to offer it depends on past falls, other health conditions and your preferences. (USPSTF, 2024)
Who is at higher risk of falling
Age is strongly linked to falls. Other risk factors the USPSTF lists are problems with memory or the senses, acute or long-term medical conditions, some medicines, hazards at home, work or in the neighborhood, and alcohol or drug use. Trials most often used a past fall to find people at higher risk, often together with problems with mobility, gait and balance. (USPSTF, 2024)
Bone strength matters too: women 65 and older are advised to have a bone density test. Read more: osteoporosis screening.
Vitamin D and falls
In 2018 the USPSTF recommended against vitamin D to prevent falls in adults 65 and older living at home. Its 2024 falls statement no longer covers vitamin D and leaves it to a separate review. (USPSTF, 2024)
That review's draft, posted December 17, 2024, recommends against vitamin D, with or without calcium, to prevent fractures, and against vitamin D to prevent falls, in postmenopausal women and men 60 and older living at home (grade D). It is a draft, not final. The final statement on fractures still in force is from 2018. (USPSTF draft, 2024, not final) (USPSTF, 2018)
This is about taking vitamin D to prevent falls or fractures. If you take it for another reason, ask your doctor before changing anything.
Questions people ask
What is the best way to prevent falls after 65?
For adults 65 and older at increased fall risk, the USPSTF recommends exercise (grade B, 2024). The programs that worked mostly trained gait, balance and everyday movement, often with strength training. (USPSTF, 2024)
Does vitamin D prevent falls?
A USPSTF draft from December 2024, not final, recommends against vitamin D to prevent falls in postmenopausal women and men 60 and older living at home (grade D). The 2024 falls statement itself does not cover vitamin D. (USPSTF draft, 2024, not final) (USPSTF, 2024)
Who counts as at increased risk of falling?
The USPSTF says age is strongly linked to falls, and that trials most often used a past fall to identify higher risk, often with problems in mobility, gait or balance. Your doctor can check your risk. (USPSTF, 2024)
Does this apply to people in nursing homes?
No. The recommendation is for older adults who live in the community, not in a nursing home or other institution. (USPSTF, 2024)
This page explains what the guidelines say. It cannot tell you what is right for you: talk to your doctor.