Why do I keep falling over for no reason?

Quick summary

Falling for no obvious reason almost always has a reason. Usually it is one of five: blood pressure dropping when you stand, a medicine or a combination of medicines, muscle weakness, eyesight, or an undiagnosed heart or neurological problem. Four of the five are treatable. Ask your GP for a falls assessment and a medication review.

Is falling over just part of getting older?

No, and the official position is clear about it. Falls become more common with age, with around a third of people aged 65 and over and around half of people aged 80 and over falling at least once a year, but government guidance states plainly that falls and fractures in older people are often preventable (Office for Health Improvement and Disparities, 2022).

“No reason” usually means no reason you can see from the outside. There was no rug, no wet floor, nothing to trip on. That points the investigation inwards, towards blood pressure, medicines and strength, rather than outwards at the house.

The five things it usually turns out to be

Why do I feel dizzy when I stand up?

That head swim has a name. Postural hypotension, sometimes called orthostatic hypotension, is a drop in blood pressure on standing from sitting or lying, and it can cause dizziness, unsteadiness, blurring and occasionally a blackout. It is more common with age and it is strongly linked to falls (Leeds Teaching Hospitals NHS Trust).

It can also happen with no symptoms at all, which is why it gets missed. It only shows up when someone measures blood pressure lying down and then standing.

Ask for that measurement by name. A lying and standing blood pressure test takes a few minutes in a GP surgery and it is one of the few tests that can explain months of unexplained falls in a single appointment.

Can my tablets be making me fall?

Often, yes, and the number of them matters as much as which ones.

Taking four or more medicines is associated with an 18 per cent increase in fall rates in people over 60, and medicines that act on the brain, including sleeping tablets, anxiety medicines and antidepressants, raise the risk further (Izza and colleagues, European Geriatric Medicine, 2020).

NICE lists psychotropic and antiarrhythmic medicines, along with polypharmacy, among the factors that raise falls risk, and recommends a medication review as part of falls management (NICE NG249, April 2025).

Take the whole list, including anything bought over the counter, to a GP or pharmacist and ask which of these could be contributing. A review may change nothing, and knowing that is useful too.

What if I have just got weaker?

Then that is the most fixable thing on the list.

Strength and balance exercise reduces the rate of falls by around 23 per cent, and the number of people who fall at all by around 15 per cent, across 108 trials involving more than 23,000 people (Cochrane, 2019). Balance and functional training improved this rate, walking on its own did not.

The NHS recommends older adults do activity every day, build up to 150 minutes of moderate activity a week, and include strength, balance and flexibility work at least twice a week (NHS physical activity guidelines for older adults).

There are free classes for this across the whole of Cheshire. Stand Strong, is a 26 week programme run by One You Cheshire East on 0300 123 5026. In Buxton and Whaley Bridge it is Live Stronger for Longer on 01773 766922. For Leek, Biddulph and Kidsgrove, start with Steady On Your Feet Staffordshire and Stoke-on-Trent.

Could it be my eyes?

Possibly, and it’s often put off the longest.

Vision problems including cataracts sit on NICE’s list of modifiable falls risk factors, and cataract surgery is named in the guidance as an intervention that can change someone’s risk. New varifocals cause their own trouble for a while, because the lower part of the lens blurs the ground exactly where you need it sharp on a staircase.

Free NHS sight tests are available to anyone aged 60 and over. It is a two week wait and a morning of your time.

What if I actually blacked out?

Say so, clearly, and say it first.

A fall where you cannot remember hitting the floor is a different problem from a fall where you tripped. NICE recommends that unexplained falls are investigated for a heart rhythm cause, including cardioinhibitory carotid sinus hypersensitivity, and that cardiac pacing is considered where it is indicated.

Families often describe this as “she just went down”. If that is what happened, use those words with the GP rather than saying she had a fall, because the two get treated very differently.

What should I ask the GP for?

Go in with four specific requests rather than a general worry.

• A lying and standing blood pressure measurement.
• A structured medication review, with the full list including anything over the counter.
• A falls assessment, or referral to the local falls service.
• A sight test and a hearing check, since inner ear problems affect balance.

One thing not to ask for. NICE now recommends against using falls risk prediction tools to predict whether someone will fall, so a score is not the point of the appointment. Finding the specific cause is.

Frequently asked questions

I have not been hurt yet. Is it still worth mentioning?

Yes. NICE guidance asks clinicians to raise falls opportunistically at routine appointments and annual health checks, which tells you they expect most falls to go unreported. Unhurt falls are the cheapest ones to learn from.

Why does it always happen at night?

Usually a combination: getting up quickly from lying flat, poor light, and sedating medicines still in your system. Sit on the edge of the bed for a slow count of twenty before standing, and put a light on rather than feeling your way.

Does it mean I am getting dementia?

Not on its own. Falls have many causes and most are physical rather than cognitive. That said, if confusion has come on over hours or days rather than months, that is a different and more urgent problem and needs a GP the same day.

Will grab rails and taking up the rugs fix it?

They help, and NICE recommends a home hazard assessment using a validated tool, ideally by an occupational therapist. But if the cause is blood pressure or a medicine, no amount of work on the house will touch it. Home changes are worth doing alongside the medical investigation, not instead of it.

Am I too old for exercise to make a difference?

The average age of participants across the Cochrane trials was 76, and three quarters were women. The effect held for people already at increased risk of falling.

About Visiting Angels Cheshire East

Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.

• You choose your caregiver. You meet them before care starts, and if it is not right you say so and we send someone else.
• No visit is ever shorter than an hour. There is no such thing as a fifteen minute call here.
• You see the same faces. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (Skills for Care, 2025).
• Carers trained in dementia, Parkinson’s, stroke recovery and complex care.
• Live-in care available, up to full time, where someone should not be on their own overnight.

Sharon’s mother had been having visits for a fortnight when she wrote this:

“It is not something we ever thought we would need but Visiting Angels have been wonderful. They came to see us to find out exactly what we needed, even though we weren’t completely sure ourselves, but through our conversation we were able to put a package of support in place. They offered advice on other things that were available to us as well particularly financially. They put our minds at ease during what was quite a stressful time in our lives. Mum has two ladies that come regularly and she has developed a relationship with them already. It gives mum somebody else to talk to, has lifted her spirit, and has provided a better routine whilst I am at work. I also know that she is eating properly and taking her medication.”

Sharon Thornton, Google review

Not sure what you need yet? Start with a free assessment

Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:

• Work out what is actually difficult, and which times of day, which is usually what a visit should be built around.
• Talk through a realistic package, and what it would cost.
• Look at the money with you, and point you towards the funding, benefits and grants you may be entitled to, including the ones most families are never told about.
• Tell you honestly if you do not need us yet, or if someone else is a better fit.

If the falls are becoming a pattern and you want to talk it through, call us on 01625 720157. You can also WhatsApp us or send an enquiry, or look at what our services cover.

Authored by Dr Niall Jawad, Managing Director, Visiting Angels Cheshire East.

Published 6 September 2026. Last updated 6 September 2026.

This article is general information, not medical advice, and no substitute for a professional who knows the person. Do not start, stop or change any medicine on the basis of it. The author is a director of the company and is not acting in a clinical capacity, and Visiting Angels Cheshire East provides personal care at home rather than medical or nursing care. Speak to a GP, a pharmacist or NHS 111 about your own situation, and call 999 in an emergency. Information correct at the date of publication. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss or injury arising from reliance on it.