A child who falls usually has no trouble getting back up. But the same isn’t true for older adults. In fact, falling is a serious health hazard: It’s the leading cause of injury-related death for people 65 and over. So it’s troubling to learn that most older adults are taking medication that makes them dizzy, weak or otherwise unsteady.

In a study published earlier this year, researchers from the State University of New York at Buffalo looked at data on medications known to increase the risk of falling. In 2017, the most recent year in the study, 94% of adults over 65 filled at least 1 prescription with a fall risk. This is up from 57% in 1999.

Also troubling: Between 1999 and 2017, the number of fall-related deaths more than doubled. The researchers couldn’t say for sure that medication was responsible for the increase, but they didn’t rule it out. (Don’t forget: Once you and your doctor decide on a medication, our app can help you save money.) Regardless, you’d be smart to assess your risk and make sure you’re doing everything you can to avoid an accident.

Why are falls so dangerous for seniors?

When older adults fall, they’re more likely to experience bone fractures or head injuries, says Wayne Jonas, MD, the executive director of Samueli Foundation’s Integrative Health Programs in Corona Del Mar, California. And because older bodies often heal more slowly, injuries are more likely to lead to complications.

Using data from 2018, researchers from the Centers for Disease Control and Prevention determined that more than 1 in 4 older adults fell at least once during the year. And more than 10% of those falls resulted in an injury.

“Even falls from ground level can have serious consequences,” says Dr. Jonas. He notes that 1 in 3 older adults who experience a short fall will die within 3 years. The fall might not be the direct cause, but for adults who are already struggling with other health issues, new injuries often make existing problems worse.

Which medications can affect my fall risk?

Medications that make you tired, dizzy or foggy-headed could increase your risk. So can those that diminish your strength or blur your vision. These are the medications to watch out for:

One problem is that older adults often metabolize medication more slowly than younger adults, says Dr. Jonas. So side effects can linger for days. 

What’s worse, some medications also increase your odds of injury. So if you do fall, you’re more likely to end up in the hospital. Dr. Jonas points specifically to benzodiazepine anticonvulsants such as clonazepam (Klonopin®), diazepam (Valium®) and lorazepam (Ativan®). (Here are 5 things you should know before taking lorazepam for anxiety.)

Some of these medications can interfere with calcium absorption, and they have been linked to lower bone quality, especially in men. In a recent study from Australia, men taking anticonvulsants had 9.1% less mineral density, which is a measure of bone strength.

Dr. Jonas also points out the risk of alcohol. “Remember that alcohol is a drug that can also reduce your balance or impair your judgment,” he says. “So you think you are okay when you are not, and that can increase risky fall-prone behavior.”

How can I reduce my risk of falls if I take a medication that increases that risk?

Don’t ignore the risk. If you take a proactive approach, you can avoid a fall-related injury, says Dr. Jonas. Here’s what he recommends.

  • Fall-proof your home. Install grab bars and handrails in the bathrooms and high-traffic areas. A contractor can help you with this. You should also make sure your home is well lit, and if you have a throw rug, make sure it’s secured with non-slip grippers or double-stick tape. Then keep your walkways clutter-free. A loose slipper or poorly placed flowerpot could result in a dangerous fall.
  • Strengthen your bones. If you do tumble, strong bones will lower the risk of a broken hip or shoulder. So target foods with calcium and vitamin D, which helps with calcium absorption.

For calcium, dairy foods are your best options, but you can also find the mineral in green leafy vegetables, according to the National Osteoporosis Foundation. For vitamin D, the easiest source is just outside your front door: Your body makes vitamin D naturally when sunlight hits your skin. So try to get outside every day. But even then, you might not get enough.

In one study from Spain, researchers estimated the amount of outdoor sunlight required to meet vitamin D needs ranged from 7 minutes in July to more than 2 hours in January. So make sure to also eat vitamin-D-rich foods such as salmon, tuna and fortified milk, especially in the winter.

For people taking anticonvulsants, Dr. Jonas recommends 15 minutes of sunshine and a supplement with both calcium and vitamin D, such as Caltrate®. (Click here to discover why you need vitamin D.)

  • Build strength. You might not be worried about washboard abs or bodybuilder biceps. But you still need strength, especially in your core. This is crucial to prevent falls and protect yourself from injury. Aim for strength training 2 to 3 times a week, says Dr. Jonas.
  • Pick up an ancient art. Eastern mind-body exercises are often gentle enough for all ages, says Dr. Jonas. And they can help improve your balance. He points to 2 in particular: tai chi and qigong. “They incorporate slow, graceful movements with deep breathing to improve balance, motor function, functional mobility, step length and cognition,” says Dr. Jonas. “Practicing either can help reduce the risk of falls by building muscle and strengthening bones.”
  • Stay in touch with your health care provider. Make sure your doctor is aware of any side effects you’re experiencing, says Dr. Jonas. “New drugs and supplements aimed at reducing falls and improving bone health are emerging every year,” he says. That means you might be able to switch to a medication that keeps you balanced.

And don’t stop a medication without talking to your doctor first, says Dr. Jonas. That can also lead to bad outcomes.

Trying new medications can be expensive, but Optum Perks is here to help. Download our discount card to access savings up 80% on your prescriptions.

Additional sources
How many older adults fall annually:
MMWR Morbidity and Mortality Weekly Report (2020). “Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years — United States, 2012–2018.”
Adults who take medication that increase fall risk: Pharmacoepidemiology & Drug Safety (2021). Trends in fall-related mortality and fall risk increasing drugs among older individuals in the United States, 1999-2017.”
Anticonvulsants and bone density: BMC Musculoskeletal Disorders (2021). Anticonvulsant use and bone health in a population-based study of men and women: cross-sectional data from the Geelong Osteoporosis Study.”
Sunlight needs for vitamin D: Science of the Total Environment (2017).Solar ultraviolet doses and vitamin D in a northern mid-latitude.