1 in 4 people 65 and 

older falls each year. 

2017 

 

Learn more about fall 

prevention. 

Stay

Independent

Learn More 

Contact your local community or senior 

center for information on exercise, fall 

prevention programs, and options for 

improving home safety, or visit: 

• go.usa.gov/xN9XA 

• www.stopfalls.org 

Centers for Disease 

Control and Prevention 

National Center for Injury 

Prevention and Control 

For more information, visit www.cdc.gov/steadi 

This brochure was produced in collaboration with the following organizations: 

VA Greater Los Angeles Healthcare System, Geriatric Research Education & 

Clinical Center (GRECC), and the Fall Prevention Center of Excellence 

1 Speak up.

 Talk openly with your healthcare

 provider about fall risks and prevention.

 Ask your doctor or pharmacist to review

 your medicines. 

2 Keep moving.

 Begin an exercise program to improve

 your leg strength and balance. 

3 Get an annual eye exam.

 Replace eyeglasses as needed. 

4 Make your home safer.

 Remove clutter and

 tripping hazards. 

Four Things You Can 

Do to Prevent Falls: 

Falls can 

lead to a loss of 

independence, but 

they are preventable. 
 

Check Your Risk for Falling
 

Circle “Yes” or “No” for each statement below Why it matters 

Yes (2) No (0) I have fallen in the past year. People who have fallen once are likely to fall again. 

Yes (2) No (0) I use or have been advised to use a cane or 

walker to get around safely. 

People who have been advised to use a cane or walker may 

already be more likely to fall. 

Yes (1) No (0) Sometimes I feel unsteady when I am walking. Unsteadiness or needing support while walking are signs of 

poor balance. 

Yes (1) No (0) I steady myself by holding onto furniture 

when walking at home. This is also a sign of poor balance. 

Yes (1) No (0) I am worried about falling. People who are worried about falling are more likely to fall. 

Yes (1) No (0) I need to push with my hands to stand up 

from a chair. This is a sign of weak leg muscles, a major reason for falling. 

Yes (1) No (0) I have some trouble stepping up onto a curb. This is also a sign of weak leg muscles. 

Yes (1) No (0) I often have to rush to the toilet. Rushing to the bathroom, especially at night, increases your 

chance of falling. 

Yes (1) No (0) I have lost some feeling in my feet. Numbness in your feet can cause stumbles and lead to falls. 

Yes (1) No (0) I take medicine that sometimes makes me feel 

light-headed or more tired than usual. 

Side effects from medicines can sometimes increase your 

chance of falling. 

Yes (1) No (0) I take medicine to help me sleep or improve 

my mood. These medicines can sometimes increase your chance of falling. 

Yes (1) No (0) I often feel sad or depressed. Symptoms of depression, such as not feeling well or feeling 

slowed down, are linked to falls. 

Total Add up the number of points for each “yes” answer. If you scored 4 points or more, you may be at risk for falling. 

Discuss this brochure with your doctor. 

This checklist was developed by the Greater Los Angeles VA Geriatric Research Education Clinical Center and affiliates and is a validated fall risk self-assessment tool (Rubenstein et al. J Safety Res; 

2011: 42(6)493-499). Adapted with permission of the authors.