Programs that have been tested in clinical trials. Resources from the CDC, AARP, and national aging organizations.
HealthGait reads the walking data already on your phone into one number in about 60 seconds, with no account — a baseline to tell whether any of this is actually working.
These programs have been evaluated in randomized controlled trials and systematic reviews. "Evidence-based" here means the research shows they actually reduce fall rates — not just risk factors.
STEADI is the CDC's clinical framework for fall prevention — the national standard used by primary care practices. The initiative provides patient-facing tools including a fall risk self-assessment, medication review guides, and the "Check for Safety" home checklist. The STEADI toolkit can be downloaded from the CDC.
Developed in New Zealand and replicated internationally, the Otago program is a specific set of leg-strengthening and balance exercises delivered by a physical therapist and practiced at home. Multiple RCTs show it reduces falls by 35% and fall-related injuries by 35% in community-dwelling older adults. Takes about 30 minutes, three times per week.
In a 2019 Cochrane review of exercise for fall prevention, tai chi led to 20% fewer people falling (8 trials, high-certainty evidence) and may cut the number of falls by 19% (7 trials, low-certainty evidence). The benefit is attributed to improvements in balance, coordination, leg strength, and proprioception. Classes are widely available at community centers, YMCAs, and senior centers.
A Matter of Balance is an 8-session group program designed to reduce fear of falling and increase physical activity in older adults. Developed at Boston University, it addresses both the physical and psychological aspects of fall risk — including the cycle where fear of falling leads to inactivity, which leads to weakness, which increases actual fall risk. Sessions are 2 hours each, led by trained coaches, and available through Area Agencies on Aging nationwide.
Financial assistance for home modifications is available through multiple programs — many people don't know about these options.
AARP's HomeFit Guide provides room-by-room home modification recommendations with illustrations. Covers bathroom, bedroom, kitchen, entryway, and outdoor modifications. Available as a download or as a printed booklet.
Download the guideArea Agencies on Aging (AAAs) administer federal and state funding for home modifications for low-income older adults. Programs vary by state but often cover grab bar installation, ramp construction, and accessibility improvements. Contact your local AAA to ask about the Home and Community-Based Services (HCBS) waiver program in your state.
Find your local AAARebuilding Together is a national nonprofit that provides home repairs and safety modifications for low-income homeowners — including older adults and people with disabilities. Services include grab bar installation, handrail repair, ramp construction, and general accessibility improvements. Volunteer-based; availability varies by location.
rebuildingtogether.orgMedicare does not typically cover home modifications, but a PT-prescribed home safety assessment is often covered under Part B. Medicaid HCBS waivers in many states cover ramps, grab bars, and other modifications for eligible beneficiaries. Contact your State Health Insurance Assistance Program (SHIP) for guidance specific to your state.
Find your SHIP counselorIf you are a clinician, use these resources to implement fall prevention protocols in your practice.
TUG, Berg, 30-second chair stand, SPPB, and gait speed with published thresholds — plus the Otago, LiFE, and Sherrington dose-response parameters that separate a program that reduces falls from one that merely happens.
Sedatives, blood pressure medications, antidepressants, antihistamines, diuretics, and diabetes medications — the specific mechanisms, deprescribing strategies, and the five questions to bring to a pharmacy visit.
The CDC STEADI clinical toolkit includes the 12-item Fall Risk Questionnaire, the Timed Up and Go (TUG) test protocol, the 30-Second Chair Stand test, the 4-Stage Balance Test, and billing guidance for fall risk assessment codes (CPT 99483, G0161). Available at cdc.gov/falls/programs/steadi.
The American Geriatrics Society's 2023 updated Beers Criteria is available through the AGS website. The full PDF can be downloaded there. The criteria include specific fall-risk medications, anticholinergic burden tools, and recommendations for alternatives. Essential for any clinician managing older adults on polypharmacy.
The scale and severity of fall injuries among older adults is often underappreciated. These numbers explain why prevention matters.
co-op.care is forming a worker-owned companion-care cooperative in Boulder, CO. Its paid care has not started yet; its care assessment, which needs no account, shows what support at home would fit.