Common Sense Health: One slip can change everything

By Dr. Gifford-Jones and Diana Gifford-Jones on June 13, 2025.

Everyone trips up now and again – sometimes figuratively, and inevitably with age, literally. Almost always, these mistakes can be avoided. Rushing is a risk factor. The wrong shoes are too. But did you know your personality may also affect your likelihood of a fall? Was this a factor in our recent father-daughter visit to the ER?

Yes, it probably was. And how do we know?

Examining the data from longitudinal studies is like looking into a medical crystal ball. If you follow people long enough, the truth has a way of revealing itself. By collecting large datasets in these studies, it’s possible to analyze detailed information on the group’s health, behaviours, environments, and medical histories. This allows the identification of patterns and correlations. We can, for example, see how changes in medication use or in physical activity can affect the likelihood of falling.

In Canada, researchers examining the Canadian Longitudinal Study on Aging found more surprising risk factors for falling among people over the age of 65. Ironically, cessation of smoking and a decrease in alcohol consumption were both predictors of increased fall risk. You read that right – increased risk! But we add, the risks of smoking at any age far outweigh the potential benefit of relaxing with a cigarette and avoiding a fall. Nevertheless, we are pleased to see the finding related to alcohol. It underscores our position that, in moderation, an alcoholic beverage can be an effective way to relax the arteries – and perhaps this research suggests the practice also upholds a familiar evening routine that reduces risk of falls. One can’t draw solid conclusions, but you know where we stand.

Now, here’s the personality part. Researchers found that individual traits – like conscientiousness and openness – offered protection. Put simply, when people are made aware of fall prevention practices, like holding onto handrails and moderating pace, and are agreeable to adjusting, they reduce their risk of falling.

You may think it’s a trifling thing to bring in the cushions from an outdoor balcony when rain begins. But this, too, is a behaviour that deserves modification. It was a minor misstep and loss of balance that had one of us missing the cushions and landing on the floor instead. Luckily, this occasion only resulted in a gash to the hand.

But even a minor misstep can lead to dire consequences. In North America, between 20-30% of adults aged 65 and older fall each year. A 2021 report found 6,579 Canadians aged 65 or older died from falls, with mortality rates steeply rising after age 80, and men more than women. Hospitalizations from falls rose 47% from 2008 to 2019 and emergency department visits have been climbing since 2010. Researchers calculated that in the U.S., falls cost patients, insurance companies and the economy nearly $80 billion each year. Those are expensive missteps!

Yet old-fashioned remedies are cheap. Here are the most common recommended steps to staying upright:

– Stay active: do daily balance and leg-strengthening exercises.

– Review medications: polypharmacy, sedatives, and blood‒pressure drugs can cause trouble.

– Fix your living space: grab bars, railings, non‒slip mats, well-lit walkways.

– Footwear matters: wear shoes with firm soles and good traction.

– Vision check: keep eyeglass prescriptions current and avoid bifocals when walking.

– Use assistive devices: canes and walkers are signs of smarts, not weakness.

– Stay social: isolation increases risk.

Now, add one more – your personality. If you are the type that rushes for balcony cushions before the rain starts, rethink it and let them get wet. Changing your behaviour might save you a gash on the hand, a broken hip, or worse.

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