Falls in Older Australians: The Statistics

The national picture: 2023-24

Falls are the single largest cause of injury in Australia, on both of the measures the Australian Institute of Health and Welfare (AIHW) reports. In its Injury in Australia: Falls series, the AIHW recorded 248,211 fall hospitalisations in 2023-24 — 43% of all injury hospitalisations, more than any other cause. In the same year there were 6,698 fall deaths, again 43% of all injury deaths and again the leading cause.

These are national, all-ages totals, but falls are heavily concentrated among older people: hospitalisation and death rates climb steeply with age, and the great majority of fall deaths are in people aged 65 and over. The financial scale matches the human one. The AIHW estimates falls cost the Australian health system about A$5 billion in 2022-23, placing them among the highest-spending conditions in the country.

Every figure on this page names its AIHW source and its year. Where a figure is specific to people aged 65 and over, it says so; where it is a national all-ages total, it says that too.

Fractures dominate, and older women are hospitalised most

Two patterns in the AIHW data matter for anyone planning around a fall.

First, when a fall lands someone in hospital, the injury is usually a broken bone. Fractures were by far the most common injury type in fall hospitalisations, accounting for 53% of cases in 2023-24, with hip and wrist fractures prominent among them. A fracture is what turns a fall from an incident into weeks of recovery — and, for an older person living alone, into a stretch of time when day-to-day independence is not guaranteed.

Second, the sexes are affected differently, and in opposite directions on the two measures. Among people aged 65 and over, 63% of fall hospitalisations were female (AIHW, Falls in older Australians 2019-20) — women are hospitalised for falls at a higher rate, partly because of higher fracture and osteoporosis risk. Fall death rates, by contrast, run higher for men. Both facts are true at once: more women are injured, and men who fall are more likely to die of it.

The population exposed

The reason falls loom so large in Australia's injury statistics is partly demographic. In 2020 an estimated 4.2 million Australians were aged 65 and over — 16% of the population — and the AIHW projects that share to reach 21-23% by 2066. As the population ages, the number of people in the age bands where falls are most frequent and most consequential grows with it.

That is the backdrop against which the response-gap question becomes urgent. A fall at 40 is usually an inconvenience; a fall at 80 can be the event that ends independent living. And the single thing that most changes the outcome of a serious fall is not covered by any of the figures above: how long the person is on the floor before anyone knows.

Why a fall is more dangerous when you live alone

The AIHW figures count falls that reached a hospital or a death certificate. They do not capture the variable that most often decides which of those a fall becomes: whether anyone was there, and how quickly help arrived. That evidence comes from clinical studies — conducted in the UK and US rather than Australia, but describing a mechanism that is not country-specific.

Most falls happen when no one else is present. In a prospective study of adults in their 90s, 82% of falls occurred when the person was alone, 80% of fallers could not get up unaided, and 30% lay on the floor for an hour or more — the clinical definition of a "long lie" (Fleming & Brayne, BMJ 2008).

The long lie is what turns a survivable fall into a fatal one. Among older people who fell at home and were on the floor for more than an hour, about half died within six months (Wild, Nayak & Isaacs, BMJ 1981). And time to discovery is the sharpest lever of all: in a study of people found helpless or dead in their homes, mortality was 12% for those found within an hour versus 67% for those down more than 72 hours, and 62% of survivors could not return to independent living (Gurley et al., NEJM 1996).

This is the gap a person living alone carries that a person in a full house does not. The fall itself is the same; the wait afterwards is not.

Where a daily check-in fits — and where it doesn't

Nothing on this page is solved by an app, and the most important response to falls is prevention: strength and balance exercise, a home-safety check, a medication review, and having eyesight and blood pressure looked at. Those are the interventions the evidence supports, and a phone cannot replace any of them.

There is one narrow thing a check-in app addresses, and it is the one the clinical studies above point straight at: the time between a fall and someone noticing. I'm Alive is a daily check-in. You confirm you're okay once a day; if you don't, the people you chose are notified — within hours, not days. It does not prevent the fall. It shortens the wait that so often decides how a fall ends.

That is a safety mechanism, not a medical device, and it is worth being exact about what it is:

I'm Alive is a daily check-in app. You confirm you're okay once a day; if you don't, the people you chose are notified — within hours, not days. The daily check-in is free (Check In, $0) and works on iPhone and Android. Even on the free plan, if you go quiet your one contact is alerted — up to once a month. Stay Protected ($29.99/year) adds full push, email and SMS escalation and up to ten contacts; Complete Safety Net ($39.99/year) adds location shared on the move. There is also a one-time Stay Connected & Travel Safely upgrade at $4.99. Free and Lifetime plans include one emergency contact; Stay Protected and Complete Safety Net allow up to ten. Phone fall detection is available on iPhone only, on Stay Protected and above, stays off until you switch it on, and only runs while the app is open — when it flags a possible fall it alerts your own chosen contacts, never emergency services, and it is best-effort, not a medical device. There is no Android fall detection.

If you or an older person you care about has had a fall, or is worried about falling, the place to start is a GP or, in Australia, healthdirect on 1800 022 222. In an emergency, call 000.