How to Prevent Falls in Advanced Parkinson’s
Neurological DisordersParkinson's Disease

Strategies to Reduce Fall Risk in Advanced Parkinson’s

Strategies to Reduce Fall Risk in Advanced Parkinson’s
Getty Images; Adobe Stock (2)
By
Published on March 13, 2026
by
Advanced Parkinson’s disease can make balance and movement more difficult, which creates a higher risk of falls.

 Falling with this movement disorder is common, and one large study review found that about 1 out of every 2 people with Parkinson’s falls at least once.

Falls can cause head injuries and break bones, so it’s important to prevent them when possible.

 “With Parkinson’s, understanding your personal [fall] risk factors and taking proactive steps can make a meaningful difference,” says Ejaz Shamim, MD, a neurologist at Kaiser Permanente in Maryland. “Falls are one of the leading causes of loss of independence as we age, but they are not inevitable.”

Below, learn what boosts Parkinson’s disease fall risk and what you can do to lower yours.

How Parkinson’s Impacts Balance and Increases Fall Risk

Parkinson’s disease changes your brain, including the parts that control your movement. And as you progress into advanced Parkinson’s, falls become the biggest reason for injury.

Advanced Parkinson’s can cause these symptoms that affect how well you move:

  • Poor Balance The result of changes in your strength, posture, reflexes, and how you move
  • Freezing of Gait When your feet feel suddenly stuck to the floor
  • Thinking Changes Trouble with focus and multitasking
  • Festination Shuffling, small, quick steps that increase the risk of tripping
  • Orthostatic Hypotension A sudden drop in blood pressure when you move from a sitting or lying to a standing position
  • Sensory Signals Inability to tell how your feet are positioned or notice an angled floor
  • Vision Problems Blurriness, seeing double, and less ability to estimate distance
Medications can also increase your risk of falls, especially when you take narcotics, some seizure medications, or many meds at once.

 Parkinson’s disease medications can also cause side effects like drowsiness and confusion, which increase fall risk.

People with advanced Parkinson's lose their ability to move automatically, so controlling how each foot moves while walking requires more focus and conscious effort, says James Liao, MD, a neurologist at Cleveland Clinic Neurological Institute in Ohio.

Because of this change, anything that disturbs someone's focus while walking can make them unsteady, says Dr. Liao.

Talking to Your Doctor About Preventing Falls

Your healthcare provider can help you lower your fall risk by addressing medications and other conditions.

“Fall prevention starts with an honest conversation,” says Dr. Shamim, who encourages his patients to bring up side effects, blood pressure issues, freezing episodes, and thinking changes so they can address them together.

Liao works with his patients to optimize medications for faster movements, less rigidity, and fewer freezing episodes. But he also looks for other possible risk factors.

“There are often specific causes of falls that can be treated,” says Liao, like vision problems, confusion, orthostatic hypotension, neuropathy, joint pain, and spinal stenosis (narrowing).

Your provider can check for changes to your hearing and vision, which can both affect balance. They can also make sure you’re getting enough vitamin D and calcium for strong bones, which protect against fractures if you have a fall.

While these nutrients help bones stay strong, you should still check with your provider first before starting any new supplement.

Physical Therapy and Movement Strategies

Physical therapy can help you stay safe from falls by teaching you personalized movement strategies, muscle-strengthening exercises, and how to use an assistive device like a walker.

Movement Cues

If you get stuck in a freezing episode, cues can get you moving again. Your physical therapist may show you cueing tips like these:

  • Pick a new move. If you can’t step forward, try stepping to the side or raising your arm instead.
  • Laser-point the way. A red dot on the floor in front of your foot can give your brain a movement goal.
  • Imagine an obstacle. Picture a stick or cane on the ground in front of you and step over it.

You have a lot more to choose from, and your therapist can help you try them until you find one that works.

For example, you can also try shifting your weight back and forth before taking a step. Or you can hum a song and try to step forward with the beat.

LSVT BIG

LSVT-BIG therapy teaches you to use bigger movements to decrease Parkinson’s symptoms. This specialized training can help you move faster and lessen repetitive movements that can increase your fall risk.

Strengthening Exercises

Your physical therapist will also ask you to do exercises designed to target specific muscles. As you get stronger, you can improve your posture, balance, and gait (how you walk).

“The earlier you build strength, balance, and safe movement habits, the better,” says Shamim. “If you have not started exercising, the best time to start is now.”

Fall Recovery

If you fall, you haven’t failed. Your physical therapist can show you how to safely get back up after a fall and how to make your home as safe as possible.

Assistive Devices

“At some point, it becomes unsafe to walk without an assistive device like a cane or walker, so these should be used when the time comes,” says Liao. Our goal is to keep people mobile and physically active for as long as possible, but we want to also prioritize safety, Liao adds.

Modifying Your Home for Fewer Fall Risks

Beyond learning new ways to move with your physical therapist, you can make some changes at home to prevent falls.

 “Simple home modifications, such as grab bars, handrails, and night lights, are powerful safety tools that reduce risk in high-traffic areas like bathrooms and hallways,” says Shamim.
You can also consider these home modification tips:

  • Remove loose rugs and clutter.
  • Place frequently used items within easy reach.
  • Install motion-sensor lights for nighttime bathroom trips.
  • Wear pants that fit well to avoid tripping on the fabric.
  • Think about removing low side or coffee tables.
  • Add color contrast to steps, ramps, or changes in flooring.
  • Use a raised toilet seat with arms you can hold onto.
  • Keep a shower bench in your bathtub or shower.
Even in the house, you can wear shoes that help you stay upright. Choose lightweight shoes with a wide base, raised toes, laces, and ankle support. Avoid options with a thick, rubbery sole that can cause tripping.

Smart Technology and Assistive Devices

In this world of smartphones and video calls, you can also take advantage of technology designed for life with Parkinson’s. “Fall detection systems, including medical alert devices and smart watches, can provide an added layer of safety and peace of mind, especially for people who live alone,” says Shamim.

Augmented-reality glasses can provide visual cues that reduce freezing episodes, says Liao. “Wearable devices can track changes in symptoms, warning clinicians and people with Parkinson's when gait is becoming more unstable, and monitoring to see if interventions like medications or therapy are helping.”

You could even ask about specialized, laser-guided walkers that project a line in front of you to keep you moving and prevent freezing.

Overcoming the Fear of Falling

If you worry about falling, you’re not alone.

 But fear of falling can lower your quality of life and make you less independent.

If you don’t keep your body moving, your muscles and bones can get weak, increasing your risk of both falling and fractures if you do take a spill.

 To process this fear and get the physical activity you need, start by following the steps above.
One study found pushing through the fear of falling and “doing it afraid” increased quality of life. But that may not be a good option for everyone. You can also lean on support from family, friends, and mental health professionals.

“If you have fallen before or feel unsteady, do not ignore it — talk with your healthcare team,” says Shamim. “Together, we can create a plan that supports mobility, safety, and quality of life.”

The Takeaway

  • Parkinson’s disease changes the way you move, and people with this condition have a much higher risk of falling.
  • You can prevent falls in advanced Parkinson's by working with a physical therapist to strengthen your muscles, learn movement cues, and use assistive devices when needed.
  • Smart technology can also offer a way to stay independent and minimize your Parkinson’s disease fall risk.
  • If you aren’t sure where to start, your healthcare provider can help you find the care and assistance you need.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Fall Prevention. Stanford Parkinson's Community Outreach. October 2025.
  2. Van Bladel A et al. Proportion of Falls Reported in Persons With Parkinson’s Disease: A Meta-Analysis. Clinical Rehabilitation. September 2023.
  3. Heyn PC et al. Falls Prevention, Home Safety, and Rehabilitation Services for People with Parkinson’s Disease: A Client and Caregiver Guide. Archives of Physical Medicine and Rehabilitation. February 8, 2023.
  4. Fall Prevention in Parkinson’s. Parkinson's Foundation.
  5. Seppala LJ et al. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others. Journal of the American Medical Directors Association. April 2018.
  6. Calcium and Vitamin D: Important for Bone Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2023.
  7. Dawson-Hughes B. Effect of Vitamin D on Risk of Falls and Fractures – The Contribution of Recent Mega-Trials. Metabolism Open. July 16, 2024.
  8. Balance Impairment and Falls in Parkinson’s Disease. American Parkinson Disease Association. June 8, 2021.
  9. Freezing of Gait in Parkinson’s Disease. American Parkinson Disease Association.
  10. Peterka M et al. LSVT-BIG Therapy in Parkinson’s Disease: Physiological Evidence for Proprioceptive Recalibration. BMC Neurology. July 11, 2020.
  11. Wong DC et al. Falls Prevention, Home Safety, and Rehabilitation Services for People with Parkinson’s Disease: A Client and Caregiver Guide. Archives of Physical Medicine and Rehabilitation. February 8, 2023.
  12. Schrodt L et al. Getting to and From the Floor: A Little Practice Can Help You Stay Independent. National Council on Aging. June 18, 2025.
  13. Dolhun R et al. What’s the Best Shoe for Parkinson’s? The Michael J. Fox Foundation. November 22, 2024.
  14. McCandless PJ et al. Effect of Three Cueing Devices for People with Parkinson’s Disease with Gait Initiation Difficulties. Gait & Posture. November 12, 2015.
  15. Jonasson SB et al. Experiences of Fear of Falling in Persons With Parkinson’s Disease – A Qualitative Study. BMC Geriatrics. February 6, 2018.
  16. Ellmers TJ et al. Does Concern About Falling Predict Future Falls in Older Adults? A Systematic Review and Meta-Analysis. Age and Ageing. April 8, 2025.
  17. Zhang Y et al. Risk Factors for Falls in Parkinson’s Disease: A Cross-Sectional Observational and Mendelian Randomization Study. Frontiers in Aging Neuroscience. June 10, 2024.
Meet Our Experts
See Our Editorial PolicyMeet Our Health Expert Network
Jessica-Baity-bio

Jessica Baity, MD

Medical Reviewer
Castle Connolly Top Doctor

Jessica Baity, MD, is a board-certified neurologist practicing in southern Louisiana. She cares for a variety of patients in all fields of neurology, including epilepsy, headache, dementia, movement disorders, multiple sclerosis, and stroke.

She received a bachelor's degree in international studies and history from the University of Miami and a master's in international relations from American University. She graduated from the Louisiana State University School of Medicine, where she also did her internship in internal medicine and her residency in neurology.

Prior to practicing medicine, she worked in international relations and owned a foreign language instruction and translation company. 

See full bio

Abby McCoy, RN

Author

Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

See full bio
See Our Editorial PolicyMeet Our Health Expert Network