Falls are the leading cause of injury, death, and emergency room visits for people over age 65 years.  Falls also rank highly for those under 65 years, despite what most people believe, or want to believe.  Some falls are unavoidable and happen purely by accident.  Unfortunately however, many are not.  Many individuals suffer from imbalance, and because the brain is so good at compensating for things, imbalance typically goes unnoticed until a fall actually occurs.  This usually happens when back up balance systems, such as visual reliance become excessively relied upon unconsciously, and then when they are not permitted to assist in balance, i.e. while walking at night and changing surfaces from a sidewalk to grass, which is much softer than cement, balance loss and a fall occurs. In the elderly however, there is more going on here than is obvious.  As humans age, the spine undergoes arthritic changes which typically begin immediately following maturation of bone, around the third decade.  These arthritic changes become observable in the 4th-5th decade for most, and by the 6th decade, become more significant.  Due to the arthritic changes in the spine, the ocular reflexes, which are in fact programmed early in age and are hard wired to the spine, are now on a different frequency than the aging spine.  It is actually this phenomena that predisposes imbalance and thus falls particularly as we age.  If these reflexive movements are not corrected for, they do not correct themselves and will only worsen with age and increased spinal degeneration. These changes are only permanent if no effort is put into reversing them.  Ask any elder who has been a patient of mine.  Most all of my patients over 55 have high fall risk associated with imbalance at the onset of treatment, and at the time of discharge, are normal, or at least significantly improved, pending their overall level of health.  In fact, imbalance is the chief presenting complete for many of my adult, (as well as younger) patients, either standalone or associated with side affects from vertigo.  The point of all this is that as we age, it is important to retrain the ocular reflexes to match that of what the spine is doing to prevent imbalance and falls.  And this exactly what I spend much of my day doing for my patients.  It is actually not very complicated or lengthy treatment, it just involves a commitment to be evaluated for balance and stability once, and then given recommendations to follow, which, are usually quite simple, much of which individuals can be easily instructed on to perform at home.