This article appears in Healthy Living Winter 2018.

While anyone can trip and fall, older folks are much more at risk of serious injury after taking a tumble.

Falls are the leading cause of injury and death for people 65 and older and can lead to hip or joint injuries, head trauma, mobility challenges, fear and anxiety, said Sean Brotherson, professor and North Dakota State University Extension family science specialist.

Even if no injury occurs, many people develop a fear of falling, which causes them to limit their activity. It can be a vicious cycle because limiting physical activity results in lost mobility and fitness, which can increase a risk of falling.

Programs designed to assist older adults to take control of their fall risk, like North Dakota’s statewide Stepping On program, improve quality of life, said Jane Strommen, assistant professor of practice and North Dakota State University Extension aging specialist.

Discuss the risk

Be proactive if you’re concerned about a family member or friend being at risk of falling.

“Most older adults desire to continue living in their own home as they age, so preventing fall-related injuries becomes increasingly important,” Strommen said.

Be assertive and ask your doctor:

— Should I have my vision checked?

— Can you tell me which of my medications might increase my risk of falling?

— Are there assistive devices (such as canes, walkers and scooters) that I should use to get around more safely?

— What type of physical activity is appropriate for me? Would a balance and strength exercise program help me?

— Can I get a referral for an occupational therapist to conduct a home assessment to reduce my risk of falls?

— Are there any community resources or classes that could help me reduce my risk of falls?

Balance requires exercise

A good exercise program builds balance, strength and flexibility.

“A physical therapist is a great resource for specialized information to help lower your risk of falling. Before embarking on an exercise program, make sure you are medically able to do the exercises,” Strommen said.

Try this standing tandem heel-toe exercise, which is practiced in the Stepping On program:

1. Stand up tall beside a counter and look straight ahead. Hold onto the counter with one hand.

2. Place one foot directly in front of the other so the feet form a straight line. Look at your feet to get them lined up, then look ahead for good posture.

3. Center your weight between your two feet. Hold this standing position for 10 seconds.

4. Change the standing position. Take the foot that was behind and place it directly in front of the other foot.

Hold this position for 10 seconds.

If the exercise is too easy, advance it by touching the counter with fingertips only or holding the position for a longer time, gradually increasing to 30 seconds. (Individuals who have had a recent hip replacement should not stand heel-to-toe without first getting permission from their doctor.)

Choose good footwear

Poor shoe choice can also result in a fall.

“Footwear should be assessed for safety. Look for a supportive shoe that has a firm arch support, is lightweight and has a sole that is flexible under the ball of the foot and not too thick,” Strommen said.

A well-fitting shoe should be roomy for comfort but snug enough to keep the heel from slipping at the back.

“Safe footwear should have a sole that grips, so look for a non-slip rubber sole that is textured for grip” with a heel that is stable and grips, Strommen said.

“We all want to wear shoes that are in style, but these shoes may not always be safe. Avoid dress shoes with smooth, leather soles, high-heeled shoes and running shoes that have a thick sole, which are easier to trip on, especially on stairs,” she said.