COPD and Fall Risk – Why Does the Risk of Falling Increase?

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COPD increases the risk of falling in several ways at once – through low oxygen levels, fatigue, muscle weakness and medication side effects. This makes everyday situations at home a real hazard, particularly in the more advanced stages of the disease.

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Why Do People with COPD Fall?

Falls in older adults rarely have a single cause. They are almost always the result of several factors working together – and in COPD, many of these factors are active simultaneously. The more severe the COPD, the more risk factors stack up, and the higher the overall fall risk [1].

The most important causes are low oxygen levels, fatigue, muscle weakness and side effects from COPD medication. Each is covered below.

Low Oxygen and Dizziness

In COPD, the lungs absorb less oxygen than normal. This means the brain and muscles are constantly working with a lower oxygen supply – and during exertion, oxygen saturation can drop even further.

Low blood oxygen can cause:

• Dizziness and near-fainting, particularly when standing up
• Confusion and reduced ability to concentrate
• Slower reaction time

It is common for people with severe COPD to feel dizzy when rising from a chair or bed. The sudden movement demands more oxygen than the body can deliver in that moment – and the result can be a fall [2].

Fatigue That Affects Balance

The fatigue that comes with COPD is not ordinary tiredness that disappears with rest. It stems from the breathing muscles working hard around the clock, from lower oxygen levels in the blood, and from the body being in a constant state of low-level stress.

This deep fatigue directly affects the ability to maintain balance. Muscles respond more slowly, coordination deteriorates, and it takes longer to correct a loss of balance. Factors that are normally compensated for automatically – an uneven surface, a doorstep, a rug – can be enough to cause a fall [1, 3].

Muscle Weakness and Sarcopenia

COPD often leads to significant muscle breakdown, a condition known as sarcopenia. This happens because:

• Low oxygen levels prevent muscles from working efficiently
• The extra energy needed for breathing leaves little for other physical activity
• Inactivity caused by breathlessness accelerates muscle breakdown further

Weak leg muscles impair balance and make it harder to stop a fall once it begins. Research shows that muscle weakness is one of the strongest individual predictors of falls in older adults [3].

COPD Medications and Fall Risk

Several medications commonly used in COPD can themselves increase fall risk:

• Corticosteroids – long-term use of oral steroids increases the risk of osteoporosis, making bones more fragile and fractures more likely after a fall
• Sedatives and anxiolytics – often used in COPD due to breathlessness-related anxiety, and known to significantly impair balance at night
• Antihypertensive drugs – can cause orthostatic hypotension, meaning a drop in blood pressure when standing that leads to dizziness [4]

Someone taking several of these medications simultaneously faces a compounded fall risk that is difficult to predict.

Osteoporosis – A Common Complication of COPD

Bone loss is so common in COPD that preventive treatment is routinely recommended for those in more advanced stages. The combination of steroid treatment, smoking, malnutrition and low physical activity breaks down bone mineral faster than normal [2].

This means that a fall which might produce only a bruise in a healthy person can result in a serious hip or vertebral fracture in someone with COPD and osteoporosis. It is one of the main reasons fall prevention measures are especially important in COPD.

Fear of Falling Creates a Negative Spiral

Many people with COPD are afraid of falling – and that fear is entirely reasonable. But it often leads to less movement – avoiding stairs, stopping walks, staying indoors. This reduces muscle strength and balance further, which in turn actually increases fall risk [3].

Breaking this spiral early matters. Adapted physical activity – ideally guided by a physiotherapist – strengthens muscles and improves balance even in more advanced stages of COPD.

Practical Steps to Reduce Fall Risk at Home

There are several straightforward steps that make the home safer:

• Remove loose rugs, cables and other trip hazards
• Ensure lighting is adequate, particularly in corridors and bathrooms
• Install grab rails in the shower and next to the toilet
• Wear supportive shoes or slippers indoors – never socks on smooth floors
• Always rise slowly from a chair or bed and wait for any dizziness to pass
• Keep a phone or alarm accessible at all times – not just in one room [1]

An occupational therapist can carry out a home visit to identify risks that are easy to overlook. This is a free service that can be arranged through the local municipality or GP surgery.

Personal alarm with automatic fall detection for people living with COPD

COPD increases the risk of falls due to fatigue, muscle weakness and low oxygen levels. Sensorem’s personal alarm is a device designed for exactly this situation: it automatically detects falls and calls relatives via the watch’s built-in speakerphone with two-way communication. The alarm works outdoors and has built-in GPS positioning.

 

READ ABOUT HOW SENSOREM’S PERSONAL ALARM AUTOMATICALLY DETECTS FALL