Heart attacks are widely recognised as medical emergencies while falls are often brushed off as accidents. But, according to doctors, after 65, a fall can be far more damaging, frequently leading to fractures, loss of mobility, and lasting dependence. For many older adults, it is the fall, not the heart attack, that marks the real turning point in health, confidence, and independence.
As Dr Tarun Suri, HOD of spine and orthopaedics at Amrita Hospital, Faridabad, puts it, “A fall in older age is not an isolated accident. It often sets off a chain reaction the body struggles to reverse.”
Here’s what that chain reaction looks like, and why it matters more than many heart attacks
Why does a fall after 65 often cause a steeper loss of independence than a non-fatal heart attack?
According to Dr Suri, a serious fall acts like a stress test that many ageing bodies fail. Fractures force immobility almost immediately, and immobility is biologically expensive after 65. Muscle mass drops rapidly, joints stiffen, balance worsens, and cardiovascular fitness declines.
“Older adults don’t rebuild muscle and coordination the way younger people do,” says Dr Tarun Suri. “Even a few weeks of reduced movement can permanently change how someone walks, stands, or climbs stairs.”
The psychological impact compounds this. Fear of falling again leads to self-imposed restriction such as less walking, fewer outings, avoidance of stairs or bathrooms without support. Functionally, everyday tasks like bathing or dressing become dependent activities.
In contrast, non-fatal heart attacks today are often followed by early mobilisation and structured cardiac rehabilitation, allowing many patients to return to independent living. Falls rarely receive that level of systematic recovery support.
Hip fractures, in particular, carry mortality risks that rival major cardiac events in older adults. A significant proportion of patients die within the first year, and survival continues to decline over five years.
“The bigger difference is not just death rates, it’s disability,” explains Dr Tarun Suri. “Survivors of hip fractures are far more likely to experience permanent mobility loss, while many heart attack survivors regain function with treatment and rehabilitation.”
“People move less because they’re scared, but that inactivity accelerates muscle loss and balance problems,” says Dr Tarun Suri. “It becomes a vicious cycle.”
Even ‘minor’ falls become life-altering events
Post-fall cascades are common: prolonged immobility, chest and urinary infections, delirium, worsening chronic disease, depression, and social isolation. Hospitalisation itself can worsen outcomes through sleep disruption and inappropriate medication use.
Even without fractures, fear-driven inactivity and family-imposed restrictions can dramatically shrink independence. In older adults, these secondary effects often cause more harm than the original
injury.
Which simple tests best predict fall risk?
According to Dr Suri, a few quick tests are useful:
- Timed up and go: Taking 12 seconds or more indicates increased fall risk
- Five-time chair-rise test: Taking more than 12 seconds suggests reduced lower-limb strength.
- Single-leg stance: Inability to balance even briefly is concerning
- Grip strength, vision, hearing, and reaction time add important context.
“Falls are rarely caused by one factor alone. These small steps identify risk early, when prevention still works,” says Dr Suri.
When should bone density testing begin?
Bone mineral density testing is routinely recommended for women from 65 onwards and for men based on individual risk factors. Crucially, any low-trauma fracture or fall-related fracture should prompt bone evaluation at any age.
“Clinical fracture history often matters more than small changes on scans,” notes Dr Tarun Suri. Repeating DEXA scans too frequently adds little value unless treatment decisions will change.
Which home changes reduce falls?
Dr Suri explains that evidence-backed fixes are low-tech including removing loose rugs, improving lighting, installing bathroom grab bars, securing stair railings, and creating a clear night-time path to the toilet.
Walking aids are often underused or poorly fitted. Indoor footwear with good grip is critical and frequently ignored. Many high-tech gadgets offer little protection unless paired with strength training and home safety changes.
What actually prevents fractures: supplements, drugs, or exercise?
According to Dr Suri, the biggest return comes from progressive strength and balance training, because it directly reduces falls. Home hazard modification and medication review follow closely.
Osteoporosis drugs reduce fracture risk in appropriately selected patients, especially after fragility fractures. Calcium and
vitamin D help when deficiencies exist, but they are not standalone solutions.
“The real protection lies in combining movement, safer homes, and bone-strengthening strategies,” says Dr Suri.
For more health updates, follow #HealthWithBS This content is for informational purposes only and is not a substitute for professional medical advice.
 "Falls after 65 can be deadlier than heart attacks, doctors warn: Here's why")
