icy climate change linked to increase in falls in montreal
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a father carries his son in his arms as he walks cautiously on an icy sidewalk on papineau ave. on dec. 29, 2025.
pierre obendrauf
/
montreal gazette
one of the possible reasons for the increase in falls among older adults observed over the past two decades is climate change, suggests dr. sidonie pénicaud, a physician with montreal’s public health department specializing in public health and preventive medicine.
“the winters we have are not the winters we had years ago,” she told the gazette. “there is more freezing and thawing — conditions that lead to icy roads and sidewalks: maybe more freezing rain. all these things can lead to more slippery conditions and more falls.”
it is known that the number of falls increases with age, starting at 60, pénicaud said. of the 6,575 montrealers hospitalized because of a fall in 2021, more than four out of five were older than 65 and, among them, 2,624 were 85 or older. that year, there were 275 deaths attributable to falls.
two recent studies, collaborations between montreal’s department of public health and urgences-santé, provided portraits of falls among older adults in the montreal area. a study on outdoor falls between 2016 and 2020 came out in 2023, and a complementary study on indoor falls between 2015 and 2021 was published in 2025.
these falls are often under-reported‚ in part because they are hard to measure, pénicaud said. “we often talk about falls as an iceberg metaphor: you have people who fall and get back up and those who fall and can’t get back up, people who fall and tell someone and those who don’t, people who call 911 or who go to hospital and people who don’t.”
falls are more common among older adults than younger ones — and their consequences, including injuries and even death, are more serious. hospitalizations often lead to physical, cognitive, psychological and social deconditioning as the quality of life declines for those injured in falls, workloads for family caregivers increase and ramifications for the health network are significant, the authors wrote.
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falls among older adults, then, are a significant public health issue. they are the leading cause of injury-related hospitalization and emergency room visits for older adults, according to parachute, canada’s injury prevention charity.
more than 60 per cent of calls to urgences-santé for outdoor falls during the study period involved ambulance transport to a hospital, the 2023 study found. these falls increased from december through february, when temperatures are freezing, during snowstorms, and when weather conditions involved ice or freezing rain.
“in this densely populated region, with its nordic climate, the elderly are at greater risk of falling and climate conditions had a marked influence on the frequency of falls,” the 15-page study concluded.
still, people fall all year long: the study noted that there were 4,892 falls reported to urgences-santé from december through february — and 8,706 from march through november.
outdoor falls during winter involving urgences-santé were most often in parking lots, followed by sidewalks, the study found. “it makes sense to prioritize those areas in terms of snow removal,” pénicaud said.
older adults are at greater risk of falling than younger ones are, but that doesn’t mean younger people don’t fall, she said. “you are less at risk of having osteoporosis, but you are still at risk of breaking something in a fall.
“you are walking on the sidewalk and it is uneven and you go flying. falls can affect everyone — and everyone can play a part in preventing them.”
municipalities can play a role — by ensuring prompt snow removal in high-traffic pedestrian areas, for instance, pénicaud said.
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because the elderly are most affected by falls and their consequences, and because this segment of the population is growing, making urban spaces more accessible should be a priority for municipalities, the study said.
“the winters we have are not the winters we had years ago,” said dr. sidonie pénicaud, a physician with montreal’s public health department. “there is more freezing and thawing — conditions that lead to icy roads and sidewalks: maybe more freezing rain. all these things can lead to more slippery conditions and more falls.”
dave sidaway
/
montreal gazette
it is recognized that the pedestrian environment can influence the gait and balance of older adults — positively or negatively, according to a 2025 report by the institut national de santé publique du québec (inspq) on deaths attributable to falls among quebecers 65 or older. this highlights the need for town or city planning, since several components of the built environment — housing, public transport and public and leisure spaces — have a role in promoting healthy aging.
the authors of the inspq report determined that falls result from various factors: a person’s health, behaviours and the environment. strategies to prevent falls, therefore, require acting on those factors. this includes evaluating the risk of falling, prescribing exercise and modifying the older adult’s environment.
despite increasing the risk of exposure to injury, exercise plays a protective role against falls, the study said: in addressing muscular weakness, which is a risk factor for falling linked to inactivity, physical activity programs are especially effective at preventing falls.
the study cites proper acute care and rehabilitation as factors in decreasing deaths associated with falls, as well as treatment of osteoporosis and sarcopenia — the loss of muscle mass, strength and function — as other measures to reduce the consequences of falls.
of montreal’s boroughs, the most outdoor falls during the study period were in ville-marie, with 1,476, or nearly 11 per cent of all falls — this despite the borough having only 4.6 per cent of the population of the island of montreal, the study found. there were 16.6 falls per 1,000 people recorded in ville-marie, compared with seven falls per 1,000 residents of the city overall.
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the 2025 study on indoor falls found that two-thirds of the callers to urgences-santé were women and the majority of falls reported were during the day — in the morning, particularly — and often in the bedroom or bathroom.
“either people were running to the toilet and fell or they got up too quickly and got dizzy,” pénicaud said.
“and you can slip and not be able to get up,” said barbara fillion, an occupational therapist and planning, programming and research agent with montreal’s public health department who is heavily engaged in fall prevention — and one of the authors of the study on indoor falls.
there is also an association between certain classes of medications and the lightheadedness and fainting that can occur when moving from lying or sitting to standing, she said. as well, kidney function is less efficient among older adults than in younger ones. so it’s not that younger people are not at risk of falling, “but you eliminate less well with age, you are also more frail and your reaction time is slower,” fillion said.
more than 60 per cent of the calls to urgences-santé involved ambulance transport to a hospital but, once the ambulance arrived, people frequently refused to be transported to hospital, the study noted. the study does not say whether the falls documented were in private homes or seniors’ residences.
the majority of falls and resulting injuries are preventable, the 20-page study concluded. it recommended that all older adults exercise regularly, follow a healthful diet and become less sedentary. (the quebec government has an online page on preventing deconditioning among seniors.)
adults already at risk for falling should participate in activities such as the free stand up! program in their neighbourhood to improve their strength and balance and make their homes safer, the study said — and those who fall frequently should have a multidisciplinary evaluation of their risk factors and participate in the development and implementation of an individualized intervention plan.
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but because the causes of falls are multi-factorial, the study said, initiatives to prevent them should go beyond individual interventions to include broader environmental strategies involving organizational, community and political structures.
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