Falls Are the Leading Cause of Injury Death After 65. Training Lowers the Risk.
Falls Prevention Awareness Week runs September 21 to 25 this year, organized by the National Council on Aging. CDC data show emergency departments recorded about 4.5 million visits for older adult falls in 2024, and falls caused more than 43,000 deaths in adults 65 and older that year, making them the leading cause of injury death in that age group. The age-adjusted fall death rate rose from 64.7 per 100,000 older adults in 2018 to 78.4 in 2024, a 21% increase in six years.
Luckily, fall risk is one of the risks we can more easily help you mitigate. The intervention with the strongest evidence behind it is exercise, monitored and prescribed correctly.
Why falls are the injury to plan against after 50
Most people start thinking about fall prevention after their first fall, but by then the picture has usually changed. A fracture typically means immobilization, immobilization means muscle and bone loss, and as muscle and bone density is lost, the odds of another fall increase.
CDC reports that over 14 million older adults, roughly 1 in 4, report falling each year, and about 37% of those who fall report an injury requiring medical treatment.
When you hit your fifties to sixties, this is your best opportunity to begin executing a plan to reduce your risk of falling in the future. Bone mineral density and muscle mass are both still responsive to load, and your training tolerance is typically higher. If you receive a DEXA scan that comes back with a T-score under -2.5, the door isn’t closed to rebuilding bone density, but it does begin to narrow what fitness regimens you can start with and how fast you can progress in that routine.
Start with a bone health assessment
What actually lowers fall risk?
The evidence speaks to exercise reducing the rate of falls by 23%.
However, not every type of exercise performed the same way.
Balance and functional training cut fall rate by 24%.
Programs combining multiple categories, usually balance and functional work plus resistance training, reduced fall rate by 34%.
Resistance training alone, walking alone, and dance did not show a clear effect on fall rate
So the specifics of the fitness routine you are engaging with truly matter. Walking is great for a long list of reasons and is not, on its own, a fall prevention program.
Loading is the second piece to the puzzle.
A recent study found evidence showing supervised high-intensity resistance and impact training improved every functional performance measure in participants with low bone density.
Talk to our team about your fall risk
What ONERO® does, and what the program's results look like
ONERO® is an award-winning, evidence-based exercise program to help improve bone density, bone structure, and bone resilience in adults with osteopenia or osteoporosis. It is built on the principle that bone needs enough mechanical load to adapt.
At neXendo Wellness, sessions run with a medical fitness trainer supervising every rep. Supervision is a condition of the protocol, not an add-on we offer. High-intensity loading in someone with low bone mass is safe when it is progressed properly by someone monitoring and instructing safe movements. It should not be attempted off a video.
ONERO® program data show a 51% reduction in falls over the last 12 months and a 78% reduction in previous fractures among participants.
Who it is for, and who needs clearance first
Good candidates:
Adults with osteopenia or osteoporosis,
Postmenopausal women with bone density loss
Anyone with a DEXA showing declining density
Older adults who have had a fall or near-fall in the last year.
An initial consultation with our team is required before enrollment in the ONERO® program to determine eligibility.
Ask whether ONERO® is right for you
What the first visit looks like
You start with an initial bone health assessment. A medical fitness trainer will monitor you through a movement and balance evaluation so we have a baseline to progress from.
If lab work or hormone evaluation is relevant, Dr. Manessis reviews it. Nutrition gets its own visit with a registered dietitian to aid in rebuilding bone density through support in food because protein intake, calcium, and vitamin D status all sit underneath whatever the training is trying to build.
We see patients in Manhattan at 235 E 38th St and in Long Island City at 36-36 33rd St Suite 311. Call 718-704-5376 with questions about scheduling or insurance.
Frequently asked questions
Is high-intensity training safe if I already have osteoporosis?
Under supervision, the evidence supports it. In the LIFTMOR trial, 49 postmenopausal women with low to very low bone mass completed eight months of high-intensity resistance and impact training with one reported adverse event, a minor back spasm.
Every ONERO® session at neXendo Wellness is supervised by a medical fitness trainer, and we screen for contraindications before you start.
How is ONERO® different from regular strength training at a gym?
ONERO® uses specific loading parameters, including ongoing supervision and re-testing to ensure the safest load and movements during training.
How long before I see results?
The LIFTMOR trial measured its BMD and functional changes at eight months of twice-weekly training. Functional improvements, meaning balance, sit-to-stand speed, and strength, usually show up earlier than density changes.
Sources
National Council on Aging, Falls Prevention Awareness Week 2026 (Sept. 21 to 25). ncoa.org
CDC, Older Adult Falls: About. ED visits and deaths, 2024. cdc.gov/falls/about
CDC, Older Adult Falls Data and Research. cdc.gov/falls/data-research
CDC STEADI, Clinical Resources. cdc.gov/steadi
Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1(1):CD012424. doi.org/10.1002/14651858.CD012424.pub2
Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. J Bone Miner Res. 2018;33(2):211-220. doi.org/10.1002/jbmr.3284