In older adults, falls may result from seizures, syncope, frailty, balance impairment, neuropathy, blood-pressure changes or medication effects. Preventing falls requires more than simply increasing antiseizure treatment.
Not every fall is a seizure
Sudden falls in an older person require a broad differential diagnosis.
Misclassifying syncope or mechanical falls as epilepsy can expose someone to unnecessary medication.
Medicines can increase fall risk
Dizziness, sedation, ataxia and visual disturbance can be dose-limiting effects of antiseizure medicines.
Older adults are particularly vulnerable when several medicines have overlapping effects.
Fear of falling can reduce activity
After a seizure-related injury, people may become less active and lose strength or confidence.
That deconditioning can itself increase future fall risk.
Physical activity can be beneficial
A 2025 review argued that physical activity is underused in older adults with epilepsy and may support cardiovascular health, mood, cognition, strength and fall prevention.
Exercise plans still need to reflect individual seizure and injury risk.
Falls prevention should be multidimensional
Medication review, vision, footwear, blood pressure, home hazards, strength and balance all matter.
The best plan addresses the cause of the fall rather than treating the label.
Related reading
Sources and further reading
- Physical activity in older adults with epilepsy — 2025
- Antiseizure medications in older adults — 2026
Evidence checked: September 2026.